Individual
JOHN DIMAGGIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
913 11TH ST SE, SUITE 2, BANDON, OR 97411-9168
(541) 347-8283
(541) 347-3632
Mailing address
913 11TH ST SE, SUITE 2, BANDON, OR 97411-9168
(541) 347-8283
(541) 347-3632
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
DP00364
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
271038
—
OR
01
—
840626000
BCBS OF OR
OR
Enumeration date
02/20/2006
Last updated
05/15/2008
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