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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 17 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 1114997145 NPPES
Indiana Other 000000383044 BLUE CROSS

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