MEDICARE: DAVID MICHAEL BANNING

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	175T00000X	Peer Specialist	PRSS-5337	NV

General Provider Information

NPI Number	:	1932087814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID MICHAEL BANNING

Provider Business Mailing Address
First Line	:	3832 PALOS VERDES ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-6905
Country	:	US
Telephone Number	:	725-895-5551
Fax Number	:

Provider Business Practice Location Address
First Line	:	3441 W SAHARA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-6061
Country	:	US
Telephone Number	:	702-445-7318
Fax Number	:

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

Provider Enumeration Date	:	08/26/2025
Last Update Date	:	08/26/2025

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Directions to “ DAVID MICHAEL BANNING ” Practice Location

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