Provider Demographics
NPI:1316320534
Name:BANDA, DEVON NICHOLAS (DO)
Entity type:Individual
Prefix:DR
First Name:DEVON
Middle Name:NICHOLAS
Last Name:BANDA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 LINWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307-1522
Mailing Address - Country:US
Mailing Address - Phone:248-802-7217
Mailing Address - Fax:
Practice Address - Street 1:THE HAND CENTER
Practice Address - Street 2:195 EASTERN BLVD, # 200
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033
Practice Address - Country:US
Practice Address - Phone:860-215-4245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-07
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101026149207X00000X, 207XS0106X
IDO-1995207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery