Provider Demographics
NPI:1033187240
Name:BANKS, SARAH ANN (DPM)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANN
Last Name:BANKS
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:250 FAME AVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-1587
Mailing Address - Country:US
Mailing Address - Phone:717-632-5264
Mailing Address - Fax:717-632-1165
Practice Address - Street 1:250 FAME AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-1587
Practice Address - Country:US
Practice Address - Phone:717-632-5264
Practice Address - Fax:717-632-1165
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASC005844213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA155384K7RMedicare PIN