Individual provider · Type 1 NPI
Kelly A. Bannasch, PA-C
Medical Physician Assistant · Detroit, MI
NPI number
1043330889
Active
Practice location
6071 W Outer Dr
Detroit, MI 48235-2624
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | 5601002420 (MI) |
Medical Physician Assistant: Definition to come...
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Other medical physician assistant providers in Detroit
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- Jamie Lauren Farrugia, M.S., PA-CMedical Physician Assistant Detroit, MI NPI 1114476652
About NPI 1043330889
Kelly A. Bannasch, PA-C's National Provider Identifier is 1043330889, issued on Mar 29, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Detroit, MI. The record was last updated on Jan 24, 2012.