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NPI Code Detail

MEDICARE: CHARLES L BANE MD

MEDICARE: CHARLES L BANE 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
1207RH0003XHematology & Oncology Physician35077949OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2000000389959OTHERANTHEM

General Provider Information

NPI Number : 1730134933
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES L BANE MD
Provider Business Mailing Address
First Line : 6680 POE AVE
Second Line : SUITE 200
City : DAYTON
State : OH
Zip : 45414-2854
Country : US
Telephone Number : 937-280-8400
Fax Number : 937-280-8373
Provider Business Practice Location Address
First Line : 8881 N MAIN ST
Second Line :
City : DAYTON
State : OH
Zip : 45415-1333
Country : US
Telephone Number : 937-293-1622
Fax Number : 937-245-6308
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2006
Last Update Date : 11/29/2022

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Directions to “ CHARLES L BANE MD” Practice Location

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