Provider Demographics
NPI:1225038060
Name:DENIER, DONNA PATRICIA (MD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:PATRICIA
Last Name:DENIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 MARY ST
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-5025
Mailing Address - Country:US
Mailing Address - Phone:828-264-9664
Mailing Address - Fax:
Practice Address - Street 1:175 MARY ST
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-5025
Practice Address - Country:US
Practice Address - Phone:828-264-9664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY203907174400000X, 207RC0000X
NC2015-01143207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01821172Medicaid
NYG68331Medicare UPIN
NY01821172Medicaid