Provider Demographics
NPI:1891956322
Name:NEUTZE, DANA MICHELLE (MD)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:MICHELLE
Last Name:NEUTZE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:590 MANNING DR
Mailing Address - Street 2:CB 7586
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-6119
Mailing Address - Country:US
Mailing Address - Phone:919-966-0210
Mailing Address - Fax:919-966-6126
Practice Address - Street 1:590 MANNING DR
Practice Address - Street 2:CB 7586
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-6119
Practice Address - Country:US
Practice Address - Phone:919-966-0210
Practice Address - Fax:919-966-6216
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-18
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC149966390200000X
NC2011-00260207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program