Provider Demographics
NPI:1962507400
Name:ANDERSON, DAYNA I (MD)
Entity Type:Individual
Prefix:DR
First Name:DAYNA
Middle Name:I
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:850 WASHINGTON ST.
Mailing Address - Street 2:FLOOR 1, SUITE 1
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026
Mailing Address - Country:US
Mailing Address - Phone:781-375-3805
Mailing Address - Fax:781-375-3810
Practice Address - Street 1:850 WASHINGTON ST.
Practice Address - Street 2:FLOOR 1, SUITE 1
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026
Practice Address - Country:US
Practice Address - Phone:781-375-3805
Practice Address - Fax:781-375-3810
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MAMA151697207R00000X
MA151697207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA04-01646OtherUNITED HEALTHCARE
MA110132778OtherRAILROAD MEDICARE
MA3083330002OtherCIGNA
MA3156117Medicaid
MA65780OtherHARVARD PILGRIM
MA151697OtherTUFTS
MAJ16984OtherBLUESHIELD
MA151697OtherTUFTS
MAG31964Medicare UPIN