Provider Demographics
NPI:1841215340
Name:SIMMERS-DABINETT, DONNA (DO)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:SIMMERS-DABINETT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:MULLICA HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08062-9469
Mailing Address - Country:US
Mailing Address - Phone:856-374-2113
Mailing Address - Fax:
Practice Address - Street 1:18 E LAUREL RD
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:NJ
Practice Address - Zip Code:08084-1327
Practice Address - Country:US
Practice Address - Phone:856-346-7816
Practice Address - Fax:856-346-6385
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB78071207P00000X
DEC2-0009166207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1841215340Medicaid
DE1841215340Medicaid