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General NPI Number Information
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NPI Number | 1063730802
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Entity Type | Individual
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Provider Name | JOSEPH R DAMAN RPH
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Gender | Male
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Dates
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Enumeration Date | 05/04/2010
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Last Update Date | 05/04/2010
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Provider Practice Location Address
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Address Line | 18430 FENKELL ST
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City | DETROIT
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State | MI
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Zip | 48223-2301
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Country | US
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Telephone | 313-837-2340
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Fax | 313-837-0884
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Provider Business Mailing Address
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Address Line | 29296 HOOVER RD
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City | WARREN
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State | MI
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Zip | 48093-3435
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Country | US
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Telephone | 586-582-0212
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302033903
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License Number State | MI
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