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Individual

DR. DAN DOUER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 639-2471
Mailing address
633 3RD AVE, BOX 3, NEW YORK, NY 10017-6706

Taxonomy

Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
Primary
261841
NY
207RH0000X
Hematology (Internal Medicine) Physician
A36194
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00A361940
BLUE SHIELD
CA
05
00A361940
CA
01
110065232
RAILROAD MEDICARE
CA
01
1356390009
GROUP NPI
CA
01
CE1617
GROUP RAILROAD MEDICARE
CA
01
GROO16910
GROUP MEDICAID PIN
CA
01
W11675
GROUP MEDICARE PIN
CA
Enumeration date
06/04/2006
Last updated
08/04/2011
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