Banta, Maureen Theresa

Banta, Maureen Theresa is an individual health care provider with primary practice located at 2500 N Van Dorn St Ste 102 , Alexandria VA 22302-1601. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Banta, Maureen Theresa can be contacted via phone (703) 933-0555.

Contact Information

Primary practice address
2500 N Van Dorn St Ste 102 Alexandria VA 22302-1601
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X D0092143 Maryland
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 0101057222 Virginia

Profile Details

NPI number 1871676122
LBN Legal business name Banta, Maureen Theresa
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 23rd, 2006
Last updated Nov 19th, 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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