1497861983 NPI number — DAVID M DANBY M.D.

Table of content: DAVID M DANBY M.D. (NPI 1497861983)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497861983 NPI number — DAVID M DANBY M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DANBY
Provider First Name:
DAVID
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497861983
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 365
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ONEIDA
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
54155-0365
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
920-869-4861
Provider Business Mailing Address Fax Number:
920-869-4979

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
525 AIRPORT DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ONEIDA
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54155-9035
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
920-869-2711
Provider Business Practice Location Address Fax Number:
920-869-4979
Provider Enumeration Date:
08/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  29247 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 110004056 . This is a "WEA" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: 390806395 . This is a "WPS" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: 390806395003 . This is a "CHAMPUS" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: B52297 . This is a "CIGNA" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: 31419800 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: X7039320002 . This is a "MANAGED HEALTH SERVICES" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: 11755 . This is a "NETWORK HEALTH" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: 00001267253 01 . This is a "UNITED HEALTH" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: 080029383 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".




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