Provider Demographics
NPI:1679764161
Name:MANN, DANA D (MD)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:D
Last Name:MANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:147 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:MA
Mailing Address - Zip Code:01949-2446
Mailing Address - Country:US
Mailing Address - Phone:978-774-2555
Mailing Address - Fax:978-887-8715
Practice Address - Street 1:147 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:MA
Practice Address - Zip Code:01949-2446
Practice Address - Country:US
Practice Address - Phone:978-774-2555
Practice Address - Fax:978-887-8715
Is Sole Proprietor?:No
Enumeration Date:2007-08-08
Last Update Date:2013-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA235825207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000845001Medicare PIN