Provider Demographics
NPI:1437848785
Name:ANKUR M BANT PLLC
Entity Type:Organization
Organization Name:ANKUR M BANT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANKUR
Authorized Official - Middle Name:M
Authorized Official - Last Name:BANT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-597-3581
Mailing Address - Street 1:8405 E BASELINE RD STE 102
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209-4376
Mailing Address - Country:US
Mailing Address - Phone:480-597-3581
Mailing Address - Fax:
Practice Address - Street 1:8405 E BASELINE RD STE 102
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-4376
Practice Address - Country:US
Practice Address - Phone:480-597-3581
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty