Provider Demographics
NPI:1295713014
Name:NEWSWANGER, DANA L (DO)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:L
Last Name:NEWSWANGER
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:PO BOX 30170
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-7170
Mailing Address - Country:US
Mailing Address - Phone:302-623-7200
Mailing Address - Fax:
Practice Address - Street 1:726 YORKLYN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:HOCKESSIN
Practice Address - State:DE
Practice Address - Zip Code:19707-8744
Practice Address - Country:US
Practice Address - Phone:302-234-5770
Practice Address - Fax:302-234-5777
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC20006267207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE188790C90Medicare PIN
DE019780C29Medicare PIN