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NPI Code Detail

MEDICARE: DR. DAMON R SOEIRO MD

MEDICARE: DR. DAMON R SOEIRO MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician223821MA
22085R0202XDiagnostic Radiology PhysicianMD428474PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023097250
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAMON R SOEIRO MD
Provider Business Mailing Address
First Line : 1 MEDICAL CENTER BLVD
Second Line : CROZER-CHESTER MEDICAL CENTER; DEPT. OF RADIOLOGY
City : UPLAND
State : PA
Zip : 19013-3902
Country : US
Telephone Number : 610-447-2595
Fax Number :
Provider Business Practice Location Address
First Line : 1 MEDICAL CENTER BLVD
Second Line : CROZER-CHESTER MEDICAL CENTER; DEPT. RADIOLOGY
City : UPLAND
State : PA
Zip : 19013-3902
Country : US
Telephone Number : 610-447-2595
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2006
Last Update Date : 04/13/2012

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Directions to “ DR. DAMON R SOEIRO MD” Practice Location

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