Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. WACHOVIA CHANTA' BANKS, D.O.
ActiveDR. WACHOVIA CHANTA' BANKS, D.O. is a Family Medicine healthcare provider located in BLYTHEWOOD, South Carolina. NPI 1487880126 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · BLYTHEWOOD, SC
Registration Details
- NPI Number
- 1487880126
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jun 9, 2009 (17.15458800956 yrs)
- Last Updated
- Jan 6, 2022
- Licenses
-
OT013286 (PA)51870 (SC)OT013286 (PA)COVID19-TMP-211 (LA)
Practice Information
- Address
-
1175 GREY PINE DRBLYTHEWOOD, SC, 290167320Browse SC providers · Browse ZIP 29016
- Phone
- 8039955599
- Primary Specialty
-
Family Medicine
207Q00000X
- Additional Specialty
- Family Medicine
- Additional Specialty
- General Practice
- Additional Specialty
- Student (Health Education/Training)
- Additional Specialty
- Family Medicine
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.