Individual provider · NPI-1

Lloyd J Banaszak Jr., MD

Family Medicine · Plymouth, MN

NPI number1700835956
StatusActive
Last updated in NPPESNov 4, 2011

Details

NPI
1700835956
Entity type
Individual (NPI-1)
Name
Lloyd J Banaszak Jr.
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
May 8, 2006
Last updated
Nov 4, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine277997MNYes

Practice location

2855 Campus Dr
Suite 400
Plymouth, MN 55441-2659

Phone 612-577-7400

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321

Phone 612-262-5000

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Family Medicine providers in Plymouth, MN