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General NPI Number Information
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NPI Number | 1578534384
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Entity Type | Individual
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Provider Name | JOHN L DAMIANI DO
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Gender | Male
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Dates
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Enumeration Date | 01/30/2006
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Last Update Date | 11/03/2023
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Provider Practice Location Address
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Address Line | 214 E ELM AVE STE 101
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City | MONROE
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State | MI
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Zip | 48162
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Country | US
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Telephone | 734-243-9620
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Fax | 734-243-3565
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Provider Business Mailing Address
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Address Line | 214 E ELM AVE STE 101
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City | MONROE
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State | MI
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Zip | 48162-2678
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Country | US
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Telephone | 734-243-9620
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Fax | 734-243-3565
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 34012721
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 5101010249
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License Number State | MI
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