Michael Eric Banwart, OD | |
2001 N Central Ave, Marshfield, WI 54449-8337 | |
(715) 486-9365 | |
(715) 486-1426 |
Full Name | Michael Eric Banwart |
---|---|
Gender | Male |
Speciality | Optometry |
Experience | 23 Years |
Location | 2001 N Central Ave, Marshfield, Wisconsin |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1295838316 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 3005-035 (Wisconsin) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Shoptikal Llc | 1456684471 | 169 |
Provider Name | Shoptikal Llc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1659937159 PECOS PAC ID: 1456684471 Enrollment ID: O20190606001553 |
Mailing Address | Practice Location Address |
---|---|
Michael Eric Banwart, OD 2401 Monique Ln Apt 2, Marshfield, WI 54449-2439 Ph: (406) 868-7836 | Michael Eric Banwart, OD 2001 N Central Ave, Marshfield, WI 54449-8337 Ph: (715) 486-9365 |
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