Provider Demographics
NPI:1972587830
Name:LANNIN, DONALD ROWE (MD)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:ROWE
Last Name:LANNIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:300 GEORGE STREET 6TH FLOOR
Mailing Address - Street 2:PO BOX 9805
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06536-0805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:800 HOWARD AVE LOWR LEVEL
Practice Address - Street 2:YALE PHYSICIANS BUILDING
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1369
Practice Address - Country:US
Practice Address - Phone:203-785-3577
Practice Address - Fax:203-737-4033
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT0402462086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001402461Medicaid
CT910000002Medicare ID - Type Unspecified
C85060Medicare UPIN