Banyash, Larry William
Banyash, Larry William is an individual health care provider with primary practice located at 2610 E Jefferson Blvd , South Bend IN 46615-2724. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Banyash, Larry William can be contacted via phone (574) 232-3000.Contact Information
Primary practice address
2610 E Jefferson Blvd
South Bend IN 46615-2724
Phone: (574) 232-3000
Fax: (574) 236-4409
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 01029868A | Indiana |
Profile Details
| NPI number | 1114997145 |
|---|---|
| LBN Legal business name | Banyash, Larry William |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 24th, 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 | 1114997145 | NPPES |
| Indiana | Other | 000000383044 | BLUE CROSS |
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