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NPI Code Detail

MEDICARE: DR. MANIBHA BANERJEE MD

MEDICARE: DR. MANIBHA BANERJEE 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
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician35038398OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154390656
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MANIBHA BANERJEE MD
Provider Business Mailing Address
First Line : PO BOX 713058
Second Line :
City : COLUMBUS
State : OH
Zip : 43271-0001
Country : US
Telephone Number : 800-288-8325
Fax Number :
Provider Business Practice Location Address
First Line : 2222 PHILADELPHIA DR
Second Line :
City : DAYTON
State : OH
Zip : 45406-1813
Country : US
Telephone Number : 937-278-6251
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2006
Last Update Date : 08/21/2007

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Directions to “ DR. MANIBHA BANERJEE MD” Practice Location

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