Healthcare Provider Details

I. General information

NPI: 1467445999
Provider Name (Legal Business Name): MICHAEL A DANSO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2005
Last Update Date: 09/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 LAKE WRIGHT DR
NORFOLK VA
23502-1871
US

IV. Provider business mailing address

5900 LAKE WRIGHT DR
NORFOLK VA
23502-1871
US

V. Phone/Fax

Practice location:
  • Phone: 757-466-8683
  • Fax: 757-466-8892
Mailing address:
  • Phone: 757-466-8683
  • Fax: 757-466-8892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number0101241940
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: