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General NPI Number Information
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NPI Number | 1366618548
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Entity Type | Individual
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Provider Name | GENIE M BANG M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/07/2008
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Last Update Date | 05/21/2021
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Provider Practice Location Address
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Address Line | 2045 N FRANKLIN ST
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City | DENVER
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State | CO
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Zip | 80205-5437
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Country | US
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Telephone | 303-338-4545
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Fax |
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Provider Business Mailing Address
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Address Line | 10350 E DAKOTA AVE
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City | DENVER
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State | CO
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Zip | 80247-1314
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 54346
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 036131009
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 105521
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License Number State | MN
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Taxonomy #4
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 054662
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License Number State | CO
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