Banov, Mark
Banov, Mark is an individual health care provider with primary practice located at 2151A Idlewood Rd , Tucker GA 30084-4816. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Banov, Mark can be contacted via phone (770) 270-1622.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 033519 | Georgia |
Profile Details
| NPI number | 1811930324 |
|---|---|
| LBN Legal business name | Banov, Mark |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 13th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1811930324 | NPPES |
| Georgia | MEDICAID | 00531297A |
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