Provider Demographics
NPI:1306035993
Name:DANILO DONA MD PC
Entity Type:Organization
Organization Name:DANILO DONA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANILO
Authorized Official - Middle Name:AGUSTIN
Authorized Official - Last Name:DONA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-586-3543
Mailing Address - Street 1:7505 GRAFTON RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:NEWPORT
Mailing Address - State:MI
Mailing Address - Zip Code:48166-8908
Mailing Address - Country:US
Mailing Address - Phone:734-586-3543
Mailing Address - Fax:734-586-3517
Practice Address - Street 1:7505 GRAFTON RD
Practice Address - Street 2:SUITE 1
Practice Address - City:NEWPORT
Practice Address - State:MI
Practice Address - Zip Code:48166-8908
Practice Address - Country:US
Practice Address - Phone:734-586-3543
Practice Address - Fax:734-586-3517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI044130207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P27840Medicare PIN