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General NPI Number Information
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NPI Number | 1760468110
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Entity Type | Individual
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Provider Name | WILLIAM PAUL BANISH MD
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Gender | Male
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Dates
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Enumeration Date | 12/19/2005
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 1450 MATTHEWS TOWNSHIP PKWY STE 250
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City | MATTHEWS
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State | NC
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Zip | 28105-5331
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Country | US
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Telephone | 704-841-1444
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Fax | 704-849-2520
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Provider Business Mailing Address
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Address Line | PO BOX 604350
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City | CHARLOTTE
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State | NC
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Zip | 28260-4350
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Country | US
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Telephone | 704-364-8100
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Fax | 704-365-2073
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 19490
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 2015-00687
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License Number State | NC
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