Healthcare Provider Details

I. General information

NPI: 1134326366
Provider Name (Legal Business Name): LEO DAMASCO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 6TH AVE STE 400
DES MOINES IA
50309-4108
US

IV. Provider business mailing address

111 HEKILI ST STE A PMB 176
KAILUA HI
96734-2800
US

V. Phone/Fax

Practice location:
  • Phone: 240-759-2477
  • Fax: 515-808-7146
Mailing address:
  • Phone: 240-338-0567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD18283
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License NumberMD18283
License Number StateHI
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD18283
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: