Mark G Bandyk, MD
Urology in Lakeland, FL. Individual provider (NPI-1).
NPI number1790778009
StatusActive
Last updated in NPPESJul 29, 2015
Details
- NPI
- 1790778009
- Entity type
- Individual (NPI-1)
- Name
- Mark G Bandyk
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 23, 2005
- Last updated
- Jul 29, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208800000X | Urology | ME89653 | FL | Yes |
Practice location
3525 Lakeland Hills BlvdLakeland, FL 33805-1965
Phone 863-603-6565 · Fax 863-904-1961
Mailing address
1324 Lakeland Hills BlvdAttn: Medical Staff Office
Lakeland, FL 33805-4543
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