| 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 | 25 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 | 192 |
| 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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