Individual
DANIELLE R MASON
Active
Individual
DANIELLE R MASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
MA051418
PA
363AS0400X
Surgical Physician Assistant
Primary
MA051418
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103153267
—
PA
01
—
50025447
CAPITAL BLUE CROSS
PA
01
—
867633
MEDICARE GROUP #
PA
01
—
MA051418
LICENSE
PA
01
—
P00164242
RAILROAD MEDICARE
PA
Enumeration date
06/16/2005
Last updated
03/07/2023
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