| Bane Medical Management Llc | |
|
415 S Lindell St Martin TN 38237-2442 | |
| (731) 255-5138 | |
| Not Available |
| Full Name | Bane Medical Management Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 415 S Lindell St, Martin, Tennessee |
| Authorized Official Name and Position | Matthew Bane (OWNER) |
| Authorized Official Contact | 8458200057 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bane Medical Management Llc 118 Hidden Hill Cv Martin TN 38237-1000 Ph: (845) 820-0057 | Bane Medical Management Llc 415 S Lindell St Martin TN 38237-2442 Ph: (731) 255-5138 |
| NPI Number | 1962103960 |
|---|---|
| Provider Enumeration Date | 03/15/2023 |
| Last Update Date | 03/27/2023 |
| Medicare PECOS PAC ID | 0840655494 |
|---|---|
| Medicare Enrollment ID | O20230503002798 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962103960 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Stefanie L Gray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891908117 PECOS PAC ID: 9830280791 Enrollment ID: I20070807000214 |
| Provider Name | Leslie A Ary |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558697540 PECOS PAC ID: 3072658285 Enrollment ID: I20100226000335 |
| Provider Name | Amber Leann Steele |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679088488 PECOS PAC ID: 4880939776 Enrollment ID: I20181220003308 |
| Provider Name | Denise Ann Shook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891492450 PECOS PAC ID: 9537524103 Enrollment ID: I20230503003554 |
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