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General NPI Number Information
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NPI Number | 1780203695
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Entity Type | Individual
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Provider Name | MARIA JEAN D'AMICO MD
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Gender | Female
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Dates
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Enumeration Date | 04/10/2020
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | CLEVELAND CLINIC FOUNDATION 9500 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44195-4409
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Country | US
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Telephone | 216-636-0537
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Fax |
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Provider Business Mailing Address
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Address Line | GLICKMAN UROLOGICAL INSTITUTE 9500 EUCLID AVE Q10
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City | CLEVELAND
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State | OH
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Zip | 44195-0001
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Country | US
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Telephone | 216-636-0537
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Fax | 216-636-4492
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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 | 35.152881
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License Number State | OH
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