Provider Demographics
NPI:1700819406
Name:HUFANA, DONNA M (MD)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:M
Last Name:HUFANA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 98978
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89193-8978
Mailing Address - Country:US
Mailing Address - Phone:702-216-3346
Mailing Address - Fax:702-671-6883
Practice Address - Street 1:3930 W CRAIG RD STE 101
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-2729
Practice Address - Country:US
Practice Address - Phone:702-473-8380
Practice Address - Fax:702-473-8383
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2019-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ43708207R00000X
TN28822207R00000X
NV16133207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV16133OtherSTATE LICENSE
NV1700819406Medicaid
TN3001321Medicaid