Provider Demographics
NPI:1689675183
Name:BANKS, PETER MURRAY (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:MURRAY
Last Name:BANKS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 INNOVATION PARK DRIVE
Mailing Address - Street 2:VENTANA MEDICAL SYSTEM
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85755
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1910 INNOVATION PARK DRIVE
Practice Address - Street 2:VENTANA MEDICAL SYSTEM
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85755
Practice Address - Country:US
Practice Address - Phone:520-229-4197
Practice Address - Fax:520-229-4162
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19204207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8912918Medicaid
NC8912918Medicaid
NC222704AMedicare ID - Type Unspecified