Provider Demographics
NPI:1518022441
Name:BANN, DAVID VINCENT (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:VINCENT
Last Name:BANN
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 1:6 GLEN COVE DR
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04856-4272
Mailing Address - Country:US
Mailing Address - Phone:207-921-8632
Mailing Address - Fax:207-921-5316
Practice Address - Street 1:6 GLEN COVE DR
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:ME
Practice Address - Zip Code:04856-4272
Practice Address - Country:US
Practice Address - Phone:207-921-8632
Practice Address - Fax:207-921-5316
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNH 92972084P0800X
MEMD174262084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0105587Y0NH01OtherANTHEM
NHP00120288OtherTRAVELERS
NH889985OtherMVP HEALTHCARE
NH889985OtherMVP HEALTHCARE
NHP00120288OtherTRAVELERS
NH52M521Medicare UPIN
ME000207001Medicare PIN