Individual
DR. MARK S DANNENBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 CARNIE BLVD, SUITE B-5, VOORHEES, NJ 08043-4512
(856) 751-0123
(856) 751-0535
Mailing address
PO BOX 1710, SOUTH JERSEY RADIOLOGY ASSOCIATES, PA, VOORHEES, NJ 08043-7710
(856) 770-0504
(856) 770-0395
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
25MA05774500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0553825000
AMERIHEALTH HMO
—
01
—
0732356
AETNA
—
01
—
10654381
CAQH
—
01
—
1092027
HORIZON NJ HEALTH
—
01
—
1243790
UNITED HEALTHCARE
—
01
—
300047103
RAILROAD MEDICARE
—
05
—
5100305
—
NJ
01
—
717161
AMERIHEALTH PPO
—
01
—
A3738029
OXFORD HEALTH
—
01
—
DA717161
PREMIER BLUE
—
Enumeration date
07/13/2005
Last updated
05/29/2012
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