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General NPI Number Information
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NPI Number | 1962596700
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Entity Type | Individual
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Provider Name | UGOALA C BANKS MD
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Gender | Male
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 07/10/2023
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Provider Practice Location Address
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Address Line | 464 ATTLEBORO CT
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City | MASON
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State | OH
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Zip | 45040-2213
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Country | US
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Telephone | 513-505-6309
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Fax | 513-486-1868
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Provider Business Mailing Address
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Address Line | PO BOX 316
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City | KINGS MILLS
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State | OH
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Zip | 45034-0316
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Country | US
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Telephone | 513-505-6309
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Fax | 513-486-1868
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 22449
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 127443
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License Number State | OH
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