MEDICARE: TIMOTHY A DAMRON 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
1	207RC0000X	Cardiovascular Disease Physician	15124	WV
2	207RC0000X	Cardiovascular Disease Physician	35.083882	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00803885	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000675429	OTHER	KY	ANTHEM BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730129578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY A DAMRON MD

Provider Business Mailing Address
First Line	:	2520 VALLEY DRIVE
Second Line	:
City	:	POINT PLEASANT
State	:	WV
Zip	:	25550
Country	:	US
Telephone Number	:	304-675-4340
Fax Number	:	304-675-6911

Provider Business Practice Location Address
First Line	:	2520 VALLEY DRIVE
Second Line	:
City	:	POINT PLEASANT
State	:	WV
Zip	:	25550
Country	:	US
Telephone Number	:	304-675-1484
Fax Number	:	304-675-1496

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	06/05/2020

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Directions to “ TIMOTHY A DAMRON MD” Practice Location

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