Stephen R. Damm, M.D., P.a.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

D0020680 Issued in MD

Legal business name

STEPHEN R. DAMM, M.D., P.A.

Practice address

9811 Mallard Dr
Suite 220
Laurel, MD 20708-3143

Phone

(301) 776-2818

Fax

(301) 369-3409

NPI assigned

Sep 17, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Stephen Robert Damm, MDNPI 1295796191

Title

President

Phone

(301) 776-2818

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stephen Robert Damm, MD

  • Dermatology Physician
  • Laurel, MD
  • NPI 1295796191

  DC

  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1253145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253145600000",
    "number": "1477886802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9811 MALLARD DR",
            "address_2": "SUITE 220",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207083143",
            "telephone_number": "301-776-2818",
            "fax_number": "301-369-3409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9811 MALLARD DR",
            "address_2": "SUITE 220",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207083143",
            "telephone_number": "301-776-2818",
            "fax_number": "301-369-3409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN R. DAMM, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-17",
        "last_updated": "2009-09-17",
        "status": "A",
        "authorized_official_last_name": "DAMM",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-776-2818",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "MD",
            "license": "D0020680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FEDERAL",
            "identifier": "0222",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSBSMD",
            "identifier": "2634SR",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Laurel, MD
• Providers in Laurel, MD by specialty
• Dermatology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.