Banham, Ivona M

Banham, Ivona M is an individual health care provider with primary practice located at 2700 Quarry Lake Dr Ste 300 , Baltimore MD 21209-3746. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Banham, Ivona M can be contacted via phone (410) 768-5555.

Contact Information

Primary practice address
2700 Quarry Lake Dr Ste 300 Baltimore MD 21209-3746
Phone: (410) 768-5555
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X C0000856 Maryland
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X C00856 Maryland

Profile Details

NPI number 1598726978
LBN Legal business name Banham, Ivona M
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2006
Last updated May 24th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598726978 NPPES
Maryland Other P00141770 R/R MEDICARE PROVIDER #
Maryland Other CN6601 R/R MEDICARE PROVIDER #

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