# JOHN L DAMIANI

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1578534384
- **Gender:** Man
- **Credential:** DO

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 34012721 | OH | — |
| 208800000X | Urology Physician | 5101010249 | MI | Yes |

## Other

- **Enumeration date:** 01/30/2006
- **Last updated:** 11/03/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0238703 | — | OH |
| 01 | — | 0E06273 | BCBSM | MI |
| 01 | — | 0H210660 | BCBSM | MI |
| 05 | — | 4265480 | — | MI |
| 01 | — | H592500 | MEDICARE PIN | OH |