Provider Demographics
NPI:1831189026
Name:DANN, ROBERT HARDING (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:HARDING
Last Name:DANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ROBERT
Other - Middle Name:H
Other - Last Name:DANN
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:23 INDIAN PIPE LN
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-3457
Mailing Address - Country:US
Mailing Address - Phone:413-253-2841
Mailing Address - Fax:
Practice Address - Street 1:164 HIGH ST
Practice Address - Street 2:DEPT. OF RADIOLOGY
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-2613
Practice Address - Country:US
Practice Address - Phone:413-773-2503
Practice Address - Fax:413-773-2139
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-27
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA34330207U00000X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2028492Medicaid
MA2028492Medicaid
MAN51546Medicare ID - Type Unspecified