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Individual
MR. MICHAEL ANDREW DANE
Active
Individual
MR. MICHAEL ANDREW DANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
006422
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004207389
—
CT
01
—
080006422CT07
ANTHEM BLUE CROSS SHIELD
CT
01
—
650016540
RAILROAD MEDICARE
CT
Enumeration date
07/07/2005
Last updated
11/03/2008
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