MEDICARE: MARGARET ELIZABETH BANGS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	WAMD24478	WA
2	207QA0000X	Adolescent Medicine (Family Medicine) Physician	WAMD24478	WA

General Provider Information

NPI Number	:	1083781140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARET ELIZABETH BANGS MD

Provider Business Mailing Address
First Line	:	908 GEORGIANA ST
Second Line	:	SAA
City	:	PORT ANGELES
State	:	WA
Zip	:	98362-3912
Country	:	US
Telephone Number	:	360-452-7080
Fax Number	:	360-457-1455

Provider Business Practice Location Address
First Line	:	908 GEORGIANA ST
Second Line	:	SAA
City	:	PORT ANGELES
State	:	WA
Zip	:	98362-3912
Country	:	US
Telephone Number	:	360-452-7080
Fax Number	:	360-457-1455

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	08/01/2007

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