MEDICARE: MRS. MARY A DANCA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	11241	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01Y003092NH01	OTHER	NH	ANTHEM ID #
2	3049618	OTHER	NH	AETNA INS ID #
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	07-01576	OTHER	NH	UNITED HEALTH CARE ID#
5	13879	OTHER	NH	HARVARD PILGRIM ID#
6	371524	OTHER	NH	MVP HEALTHCARE ID#
7	37325	OTHER	NH	CIGNA ID #

General Provider Information

NPI Number	:	1770586497
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARY A DANCA M.D.

Provider Business Mailing Address
First Line	:	250 PLEASANT ST
Second Line	:
City	:	CONCORD
State	:	NH
Zip	:	03301-7539
Country	:	US
Telephone Number	:	603-228-7200
Fax Number	:	603-228-7307

Provider Business Practice Location Address
First Line	:	250 PLEASANT ST
Second Line	:
City	:	CONCORD
State	:	NH
Zip	:	03301-7539
Country	:	US
Telephone Number	:	603-228-7200
Fax Number	:	603-228-7307

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	07/09/2007

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