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General NPI Number Information
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NPI Number | 1316320534
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Entity Type | Individual
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Provider Name | DEVON NICHOLAS BANDA DO
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Gender | Male
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Dates
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Enumeration Date | 07/07/2015
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Last Update Date | 06/14/2024
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Provider Practice Location Address
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Address Line | THE HAND CENTER 195 EASTERN BLVD, # 200
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City | GLASTONBURY
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State | CT
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Zip | 06033
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Country | US
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Telephone | 860-215-4245
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Fax |
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Provider Business Mailing Address
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Address Line | 317 LINWOOD AVE
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City | ROCHESTER
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State | MI
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Zip | 48307-1522
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Country | US
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Telephone | 248-802-7217
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 5101026149
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | O-1995
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | O-1995
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License Number State | ID
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Taxonomy #4
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | 5101026149
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License Number State | MI
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