Provider Demographics
NPI:1053432872
Name:BANKA, SAHIL SAGAR (MD)
Entity type:Individual
Prefix:DR
First Name:SAHIL
Middle Name:SAGAR
Last Name:BANKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 N BROAD ST
Mailing Address - Street 2:2ND FLOOR, FEINSTEIN BUILDING
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-1121
Mailing Address - Country:US
Mailing Address - Phone:215-762-3333
Mailing Address - Fax:215-762-2312
Practice Address - Street 1:216 N BROAD ST
Practice Address - Street 2:2ND FLOOR, FEINSTEIN BUILDING
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-1121
Practice Address - Country:US
Practice Address - Phone:215-762-3333
Practice Address - Fax:215-762-2312
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006025386207R00000X
PAMD436937207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102605020Medicaid
PA002625738OtherHIGHMARK B/S