Healthcare Provider Details

I. General information

NPI: 1760390918
Provider Name (Legal Business Name): IAN FREDERICK DAMM-LUHR RN, NRP
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 ELKRIDGE LANDING RD
LINTHICUM HEIGHTS MD
21090-2917
US

IV. Provider business mailing address

22 S GREENE ST
BALTIMORE MD
21201-1544
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-1234
  • Fax:
Mailing address:
  • Phone: 410-328-1102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberR190679
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: