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General NPI Number Information
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NPI Number | 1194710780
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Entity Type | Individual
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Provider Name | ANTHONY SHAWN BANKES M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/20/2005
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 2803 MEDICAL CAMPUS DRIVE
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City | SEYMOUR-JOHNSON AFB
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State | NC
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Zip | 27531
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Country | US
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Telephone | 919-722-1580
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Fax |
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Provider Business Mailing Address
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Address Line | 110 N PURDY ST
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City | SUMTER
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State | SC
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Zip | 29150-4525
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2017-01552
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01055345A
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License Number State | IN
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