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Individual

DR. EDWIN STEVEN DAMON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
64 PALOMBA DR, ENFIELD, CT 06082-3844
(860) 745-6248
(860) 741-2482
Mailing address
64 PALOMBA DR, ENFIELD, CT 06082-3844
(860) 745-6248
(860) 741-2482

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
000035
CT
213E00000X
Podiatrist
1422
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0313211
MA
01
1019700001
NSC
CT
05
4006102
CT
Enumeration date
08/16/2006
Last updated
11/27/2007
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