Banks, Wachovia Chanta'
Banks, Wachovia Chanta' is an individual health care provider with primary practice located at 1175 Grey Pine Dr , Blythewood SC 29016-7320. She recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / General Practice, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Banks, Wachovia Chanta' can be contacted via phone (803) 995-5599.Contact Information
Primary practice address
1175 Grey Pine Dr
Blythewood SC 29016-7320
Phone: (803) 995-5599
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | OT013286 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 51870 | South Carolina |
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | OT013286 | Pennsylvania |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | COVID19-TMP-211 | Louisiana |
Profile Details
| NPI number | 1487880126 |
|---|---|
| LBN Legal business name | Banks, Wachovia Chanta' |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 9th, 2009 |
| Last updated | Jan 6th, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487880126 | NPPES |
| South Carolina | MEDICAID | 518700 | |
| South Carolina | MEDICAID | 2570986 |
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