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General NPI Number Information
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NPI Number | 1851354898
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Entity Type | Individual
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Provider Name | LOUIS D'AMICO MD
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Gender | Male
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Dates
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Enumeration Date | 04/10/2006
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Last Update Date | 06/18/2012
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Provider Practice Location Address
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Address Line | 125 E BROAD ST SUITE 208
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City | ELYRIA
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State | OH
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Zip | 44035-6400
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Country | US
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Telephone | 440-329-7315
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Fax | 440-329-7316
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Provider Business Mailing Address
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Address Line | 125 E BROAD ST SUITE 208
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City | ELYRIA
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State | OH
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Zip | 44035-6400
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Country | US
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Telephone | 440-329-7315
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Fax | 440-329-7316
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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 | 35039947D
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License Number State | OH
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