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General NPI Number Information
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NPI Number | 1104811405
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Entity Type | Organization
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Legal Business Name | EAST CENTRAL ONCOLOGY ASSOCIATES
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Dates
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Enumeration Date | 09/13/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4011 ORCHARD DR SUITE 1000
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City | MIDLAND
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State | MI
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Zip | 48640-6190
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Country | US
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Telephone | 989-631-3975
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Fax | 989-631-4844
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Provider Business Mailing Address
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Address Line | 4011 ORCHARD DR SUITE 1000
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City | MIDLAND
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State | MI
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Zip | 48640-6190
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Country | US
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Telephone | 989-631-3975
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Fax | 989-631-4844
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Authorized Official
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Title or Position | PHYSICIAN ASSOCIATE
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Name | DANIEL YAW DANSO
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Credential | MD
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Telephone | 989-631-3975
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 4301079365
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License Number State | MI
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