Individual
DR. KENNETH EDWARD DAMATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
100 SENECA ROAD, ELKINS, WV 26241-1457
(304) 636-8080
(304) 636-8849
Mailing address
CENTRAL WV MEDCORP, INC., PO BOX 2630, ELKINS, WV 26241-2630
(304) 637-3799
(304) 637-3369
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
1153
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0097229000
—
WV
01
—
P00247557
RAILROAD MEDICARE
—
01
—
WV01153
HEALTH PLAN
WV
Enumeration date
07/10/2006
Last updated
01/14/2008
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