Provider Demographics
NPI:1356464721
Name:EDIL, BANU (MD)
Entity Type:Individual
Prefix:DR
First Name:BANU
Middle Name:
Last Name:EDIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BANU
Other - Middle Name:
Other - Last Name:TINJUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:707 S MILLS ST
Mailing Address - Street 2:ST MARY'S HOSPITAL, MADISON EMERGENCY PHYSICIANS (MEP)
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53715-1849
Mailing Address - Country:US
Mailing Address - Phone:608-258-6504
Mailing Address - Fax:
Practice Address - Street 1:707 S MILLS ST
Practice Address - Street 2:ST MARY'S HOSPITAL, MADISON EMERGENCY PHYSICIANS (MEP)
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53715-1849
Practice Address - Country:US
Practice Address - Phone:608-258-6504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI51643-20207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine