Provider Demographics
NPI:1558360420
Name:BANKS, LOUISE YVONNE (MD)
Entity Type:Individual
Prefix:DR
First Name:LOUISE
Middle Name:YVONNE
Last Name:BANKS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6387 DOUGLAS ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-1821
Mailing Address - Country:US
Mailing Address - Phone:412-736-3876
Mailing Address - Fax:412-521-2442
Practice Address - Street 1:6387 DOUGLAS ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-1821
Practice Address - Country:US
Practice Address - Phone:412-736-3876
Practice Address - Fax:412-521-2442
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD047820L2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014294440007Medicaid
PA0014294440007Medicaid
PAF67152Medicare UPIN