Provider Demographics
NPI:1689076515
Name:FEUILLET, DANA (PA)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:FEUILLET
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:
Other - Last Name:ZOVKO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PAC
Mailing Address - Street 1:8110 MAPLE LAWN BLVD STE 235
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MD
Mailing Address - Zip Code:20759-2694
Mailing Address - Country:US
Mailing Address - Phone:301-340-8339
Mailing Address - Fax:301-340-9027
Practice Address - Street 1:1165 IMPERIAL DR
Practice Address - Street 2:SUITE 300
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-6555
Practice Address - Country:US
Practice Address - Phone:301-665-9098
Practice Address - Fax:301-665-1373
Is Sole Proprietor?:No
Enumeration Date:2014-09-23
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA057196363AM0700X
MDMDC0006025363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical