Individual
IVAN A. DONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
10101 ACADEMY RD, SUITE 104, PHILADELPHIA, PA 19114-1120
(215) 632-4000
(215) 632-1661
Mailing address
P. O. BOX 8500 - 6335, PHILADELPHIA, PA 19178-0001
(215) 807-8000
(215) 807-8235
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS002544L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007121900001
—
PA
05
—
0007121900003
—
PA
05
—
0007121900004
—
PA
01
—
0057944000
IBC,KEYSTONE
PA
01
—
00712190-02
AMERICHOICE
PA
01
—
049399
HIGHMARK BLUE SHIELD
PA
01
—
080104782
RAILROAD MEDICARE
PA
01
—
1025952
KEYSTONE MERCY
PA
01
—
1103032
CIGNA
PA
01
—
18170
HEALTH PARTNERS
PA
01
—
19193
AETNA
PA
01
—
3235
CLEARCARE
PA
01
—
408040
UNITED HEALTHCARE
PA
01
—
810159625
PHCS
PA
01
—
PA0049560
TRICARE
PA
Enumeration date
05/06/2006
Last updated
06/19/2015
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