Provider Demographics
NPI:1104160001
Name:DANA, MICHAEL (PA-C)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:DANA
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 OVERLOOK RD STE B
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-3319
Mailing Address - Country:US
Mailing Address - Phone:828-483-5778
Mailing Address - Fax:828-333-5360
Practice Address - Street 1:31 CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:NC
Practice Address - Zip Code:28752
Practice Address - Country:US
Practice Address - Phone:828-255-7776
Practice Address - Fax:828-274-5134
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP01216264OtherRR MEDICARE
NCNCD212AMedicare PIN