Provider Demographics
NPI:1376678367
Name:DR. ROSARIO G DANCEL MD
Entity Type:Organization
Organization Name:DR. ROSARIO G DANCEL MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:ROSARIO
Authorized Official - Middle Name:
Authorized Official - Last Name:DANCEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-749-0300
Mailing Address - Street 1:6196 OXON HILL RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-3100
Mailing Address - Country:US
Mailing Address - Phone:301-749-0300
Mailing Address - Fax:301-749-0303
Practice Address - Street 1:6196 OXON HILL RD
Practice Address - Street 2:SUITE 150
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-3100
Practice Address - Country:US
Practice Address - Phone:301-749-0300
Practice Address - Fax:301-749-0303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00155742080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD231691OtherANTHEM HEALTH KEEPERS PLU
MD407481OtherAETNA US HEALTHCARE PPO
MD079956OtherAETNA US HEALTHCARE HMO
MD58692OtherAMERIGROUP
MD968291100Medicaid