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1114997145
LARRY WILLIAM BANYASH
SOUTH BEND, IN
NPI
1114997145
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Primary Taxonomy
207Q00000X Family Medicine
(Licence: IN 01029868A)
Enumeration Date
2006-01-24
Last Update Date
2007-07-08
Business Address
LARRY WILLIAM BANYASH MD
2610 E JEFFERSON BLVD
SOUTH BEND, IN 46615-2724
Phone number: 574-232-3000
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Mailing Address
LARRY WILLIAM BANYASH MD
2610 E JEFFERSON BLVD
SOUTH BEND, IN 46615-2724
Phone number: 574-232-3000
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