Individual
DR. DAMIAN MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
16230 SUMMERLIN RD STE 215, FORT MYERS, FL 33908-5769
(239) 343-6050
(239) 343-9909
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-6050
(239) 343-9909
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
22268
WV
2086S0120X
Pediatric Surgery Physician
Primary
ME129852
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020940500
—
FL
05
—
3810006087
—
WV
01
—
P00358613
RAILROAD MEDICARE
WV
Enumeration date
08/01/2006
Last updated
03/29/2021
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