Individual provider · NPI-1

Dr. Renee Marie Banaszak, MD

Family Medicine · Greenville, NC

NPI number1356408272
StatusActive
Last updated in NPPESApr 18, 2012

Details

NPI
1356408272
Entity type
Individual (NPI-1)
Name
Dr. Renee Marie Banaszak
Credential
MD
Sex
Female
Sole proprietor
No
Enumeration date
Jan 2, 2007
Last updated
Apr 18, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine2006-01968NCYes

Practice location

101 Heart Drive
Ecu Physicians Family Medicine
Greenville, NC 27834

Phone 252-744-4611 · Fax 252-744-3201

Mailing address

Po Box 751069
Charlotte, NC 28275-1069

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