Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Conor Whitley Banta, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1114715224

Conor Whitley Banta, MD is a Student in an Organized Health Care Education/Training Program in Providence, Rhode Island. Licensed in Rhode Island. Registered with an NPI since 2025.

Licensed in
RI
In the registry since
2025
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

593 Eddy St
Providence, RI 02903-4923
Phone: (401) 444-4741
Fax: (401) 444-4445
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X · Licence LP06508 (RI)

Record details

NPI number1114715224
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 28, 2025
Last updated in NPPESApril 28, 2025
Certification dateApril 28, 2025
Mailing address593 Eddy St, Providence, RI 02903-4923

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