Healthcare Provider Details

I. General information

NPI: 1295723930
Provider Name (Legal Business Name): FRANK L D'AMELIO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 02/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 PEACH ORCHARD RD
MC CONNELLSBURG PA
17233-8559
US

IV. Provider business mailing address

322 E. ANTIETAM STREET SUITE 106
HAGERSTOWN MD
21740-5736
US

V. Phone/Fax

Practice location:
  • Phone: 717-485-6847
  • Fax: 717-485-6848
Mailing address:
  • Phone: 240-527-2000
  • Fax: 301-739-6163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License NumberMD055929L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD055929L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0015220370002
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 2
IdentifierP00736013
Identifier TypeOTHER
Identifier State
Identifier IssuerMEDICARE RAILROAD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: