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Patient Banza
NPI 1790649721 · on the registry since 2025
Practice
- Address
- 2020 N Interlachen Way
Meridian, ID 83646 - Phone
- (208) 964-0441
Registry record
- Primary taxonomy
- 106S00000X
106S00000X
- Licence states on file
- ID
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2025-12-13
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho