Provider Demographics
NPI:1689463408
Name:4B BANSALS BRAIN BODY & BEHAVIORAL CLINIC LLC
Entity type:Organization
Organization Name:4B BANSALS BRAIN BODY & BEHAVIORAL CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GIRRAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:BANSAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-864-3434
Mailing Address - Street 1:10330 SAWMILL PKWY
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-7790
Mailing Address - Country:US
Mailing Address - Phone:614-864-3434
Mailing Address - Fax:
Practice Address - Street 1:10330 SAWMILL PKWY
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-7790
Practice Address - Country:US
Practice Address - Phone:614-864-3434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty