Healthcare Provider Details

I. General information

NPI: 1730403353
Provider Name (Legal Business Name): DAMON A DELEON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2010
Last Update Date: 06/02/2021
Certification Date: 06/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

428 BILTMORE AVE
ASHEVILLE NC
28801-4502
US

IV. Provider business mailing address

PO BOX 800136
CHARLOTTESVILLE VA
22908-0136
US

V. Phone/Fax

Practice location:
  • Phone: 865-250-1388
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number0056850
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number2020-04255
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: