MEDICARE: DR. MICHAEL STUART BANKS 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	207R00000X	Internal Medicine Physician	232281	NY

General Provider Information

NPI Number	:	1942525399
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL STUART BANKS MD

Provider Business Mailing Address
First Line	:	295 PARK AVE S
Second Line	:	SUITE 8A
City	:	NEW YORK
State	:	NY
Zip	:	10010-4503
Country	:	US
Telephone Number	:	917-822-2060
Fax Number	:

Provider Business Practice Location Address
First Line	:	295 PARK AVE S
Second Line	:	SUITE 8A
City	:	NEW YORK
State	:	NY
Zip	:	10010-4503
Country	:	US
Telephone Number	:	917-822-2060
Fax Number	:

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

Provider Enumeration Date	:	03/29/2010
Last Update Date	:	03/29/2010

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