Keith Charles Damico, PAC
Individual provider Active NPI Medical Physician Assistant · Marion, NC
NPI 1285704585 · NPPES record last updated Jul 30, 2009
Key facts
- NPI
- 1285704585
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- 102719 (NC)
- Practice address
- 5235 NC 226 S
Marion, NC 28752-8733 - Phone
- (828) 766-7278
- Fax
- (822) 766-2849
- NPI assigned
- Nov 8, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 102719 | NC | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health-Pro Mental Health Services PLLC | Past | Accepting new patients | |
| East Asheville Family Health Care P.a. | Past |
Accepting new patients | |
| Diaa E Hussein MD LLC | Past | Accepting new patients | |
| Keith C Damico PA C Professional Association | Medical | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 102719 | NC | Yes |
Addresses
Primary practice location
5235 NC 226 S
Marion, NC 28752-8733
Mailing address
PO Box 448
Crossnore, NC 28616-0448
Phone (828) 766-7278
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89018TB | Medicaid | NC |
Other providers in Marion, NC
- Jenna Crawford-Meyers
- Martha Stone Crenshaw
- Crossroads Recovery Center, Incorporated
- April Nicole Crummie
- Rhett Crummie
- Michael Dana
- Alisha Davall
- Wesley Adam Davenport
- Alisha Rogers Davis
- Jennifer C Davis
All providers in Marion, NC · Medical Physician Assistant in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 30, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.