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Individual

JOHN L DAMIANI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
214 E ELM AVE STE 101, MONROE, MI 48162
(734) 243-9620
(734) 243-3565
Mailing address
214 E ELM AVE STE 101, MONROE, MI 48162-2678
(734) 243-9620
(734) 243-3565

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
34012721
OH
208800000X
Urology Physician
Primary
5101010249
MI

Other

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
Enumeration date
01/30/2006
Last updated
11/03/2023
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