Provider Demographics
NPI:1558464149
Name:HERMANN D. BANKS, M.D., P.C.
Entity Type:Organization
Organization Name:HERMANN D. BANKS, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HERMANN
Authorized Official - Middle Name:D
Authorized Official - Last Name:BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-525-5744
Mailing Address - Street 1:14700 FARMINGTON RD STE 102
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-5434
Mailing Address - Country:US
Mailing Address - Phone:734-525-5744
Mailing Address - Fax:734-525-3932
Practice Address - Street 1:14700 FARMINGTON RD STE 102
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-5434
Practice Address - Country:US
Practice Address - Phone:734-525-5744
Practice Address - Fax:734-525-3932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4094874Medicaid
MIG94845Medicare UPIN
MI4094874Medicaid