Provider Demographics
NPI:1922024637
Name:DONA, DANILO AGUSTIN (MD)
Entity Type:Individual
Prefix:DR
First Name:DANILO
Middle Name:AGUSTIN
Last Name:DONA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7505 GRAFTON RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:NEWPORT
Mailing Address - State:MI
Mailing Address - Zip Code:48166-8908
Mailing Address - Country:US
Mailing Address - Phone:734-586-3543
Mailing Address - Fax:734-586-3517
Practice Address - Street 1:7505 GRAFTON RD
Practice Address - Street 2:SUITE 1
Practice Address - City:NEWPORT
Practice Address - State:MI
Practice Address - Zip Code:48166-8908
Practice Address - Country:US
Practice Address - Phone:734-586-3543
Practice Address - Fax:734-586-3517
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI044130207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0805800271OtherBLUE CROSS BLUE SHIELD OF
MI1480779Medicaid
MIP27840001Medicare PIN
MI0805800271OtherBLUE CROSS BLUE SHIELD OF