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General NPI Number Information
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NPI Number | 1700657442
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Entity Type | Individual
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Provider Name | MICHAEL JOHN BANNING RRT
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Gender | Male
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Dates
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Enumeration Date | 01/11/2024
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Last Update Date | 01/11/2024
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Provider Practice Location Address
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Address Line | 800 HOSPITAL DR
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City | COLUMBIA
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State | MO
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Zip | 65201-5275
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Country | US
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Telephone | 573-814-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 304 MUMFORD DR
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City | COLUMBIA
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State | MO
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Zip | 65203-0230
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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 | 227900000X
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Taxonomy Name | Registered Respiratory Therapist
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License Number | 2007010643
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License Number State | MO
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