Individual
TIMOTHY A DAMRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2520 VALLEY DRIVE, POINT PLEASANT, WV 25550
(304) 675-1484
(304) 675-1496
Mailing address
2520 VALLEY DRIVE, POINT PLEASANT, WV 25550
(304) 675-4340
(304) 675-6911
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
15124
WV
207RC0000X
Cardiovascular Disease Physician
35.083882
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000290591
OH MEDICAID UNISON
OH
01
—
000000675429
ANTHEM BCBS
KY
05
—
0073423000
—
WV
01
—
0779439
OH MEDICAID MOLINA
OH
05
—
0779439
—
OH
01
—
310917085220
OH MEDICAID CARESOURCE
OH
05
—
64071400
—
KY
01
—
P00803885
RAILROAD MEDICARE
OH
Enumeration date
06/08/2006
Last updated
06/05/2020
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