Banwart, Bruce Douglas

Banwart, Bruce Douglas is an individual health care provider with primary practice located at 1417 S Cliff Ave Ste 201 , Sioux Falls SD 57105-1009. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine, which is considered as his primary health care specialty. Banwart, Bruce Douglas can be contacted via phone (605) 322-3666.

Contact Information

Primary practice address
1417 S Cliff Ave Ste 201 Sioux Falls SD 57105-1009
Phone: (605) 322-3666
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X 2015008610 Missouri
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X 12415 South Dakota

Profile Details

NPI number 1811945439
LBN Legal business name Banwart, Bruce Douglas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 5th, 2006
Last updated Mar 24th, 2021 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811945439 NPPES
Missouri MEDICAID 205855109
Missouri MEDICAID 100421570A

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