Provider Demographics
NPI:1770586497
Name:DANCA, MARY A (MD)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:A
Last Name:DANCA
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 1:250 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-7539
Mailing Address - Country:US
Mailing Address - Phone:603-228-7200
Mailing Address - Fax:603-228-7307
Practice Address - Street 1:250 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-7539
Practice Address - Country:US
Practice Address - Phone:603-228-7200
Practice Address - Fax:603-228-7307
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH11241207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH01Y003092NH01OtherANTHEM ID #
NH3049618OtherAETNA INS ID #
NH8030001Medicaid
NH07-01576OtherUNITED HEALTH CARE ID#
NH13879OtherHARVARD PILGRIM ID#
NH371524OtherMVP HEALTHCARE ID#
NH37325OtherCIGNA ID #
NH3049618OtherAETNA INS ID #
NH371524OtherMVP HEALTHCARE ID#