| Dr Renee Marie Banaszak, MD | |
|
101 Heart Drive, Ecu Physicians Family Medicine, Greenville, NC 27834 | |
| (252) 744-4611 | |
| (252) 744-3201 |
| Full Name | Dr Renee Marie Banaszak |
|---|---|
| Gender | Female |
| Speciality | Family Medicine |
| Location | 101 Heart Drive, Greenville, North Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356408272 | NPI | - | NPPES |
| 5909976 | Medicaid | NC | |
| 1464R | Other | NC | BCBSNC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 2006-01968 (North Carolina) | Primary |
| Entity Name | Vidant Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477648731 PECOS PAC ID: 0345343893 Enrollment ID: O20070321000445 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Renee Marie Banaszak, MD Po Box 751069, Charlotte, NC 28275-1069 Ph: () - | Dr Renee Marie Banaszak, MD 101 Heart Drive, Ecu Physicians Family Medicine, Greenville, NC 27834 Ph: (252) 744-4611 |
Dr. Giselle Devonne Blair, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 315 W 2nd St, Greenville, NC 27834 Phone: 252-507-0588 Fax: 855-937-0774 | |
Dr. Emily L Bray, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 101 Heart Dr, Greenville, NC 27834 Phone: 252-744-4611 Fax: 252-744-3201 | |
Dr. Shivajirao Prakash Patil, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 101 Heart Dr, Greenville, NC 27834 Phone: 252-744-4611 Fax: 252-744-3040 | |
Dr. Jessica Lee Zimmerman, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 101 Heart Dr, Greenville, NC 27834 Phone: 252-744-4611 Fax: 252-744-3201 | |
Dr. Ashton Fox Johnson, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2100 Stantonsburg Rd, Greenville, NC 27834 Phone: 252-744-4757 Fax: 252-744-5014 | |
Dr. Celeste T. Jackson, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1204 E Fire Tower Rd, Greenville, NC 27858 Phone: 252-744-1122 Fax: 252-744-1133 | |
Dr. Sean Carl Vidulich, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1204 E Fire Tower Rd, Greenville, NC 27858 Phone: 252-744-1122 Fax: 252-744-1133 |