Provider Demographics
NPI:1962407650
Name:BANAS, ZUZANA RAJECKA (MD)
Entity type:Individual
Prefix:
First Name:ZUZANA
Middle Name:RAJECKA
Last Name:BANAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 19305
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28219-9305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15110 JOHN J DELANEY DR
Practice Address - Street 2:STE 200
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-3544
Practice Address - Country:US
Practice Address - Phone:704-302-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9901295207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC144157OtherSOUTHCARE PPO
NC1945657OtherUNITED HEALTHCARE
NC7379304OtherAETNA
NC1245COtherBCBS OF NC
NC277867OtherMAMSI
NC39509OtherPARTNERS MEDICARE
NC891245CMedicaid
NC21176OtherCIGNA
NC93941OtherMEDCOST
NC144157OtherSOUTHCARE PPO
NC277867OtherMAMSI
NC2281134Medicare PIN