Individual
DR. MARK S DANNENBAUM
Active
Individual
DR. MARK S DANNENBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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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