Provider Demographics
NPI:1053487223
Name:ASSOCIATES IN EAR NOSE AND THROAT SURGERY PC
Entity Type:Organization
Organization Name:ASSOCIATES IN EAR NOSE AND THROAT SURGERY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:DAMIANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-441-8711
Mailing Address - Street 1:7500 HANOVER PARKWAY
Mailing Address - Street 2:SUITE 207
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2009
Mailing Address - Country:US
Mailing Address - Phone:301-441-8711
Mailing Address - Fax:301-441-4859
Practice Address - Street 1:7500 HANOVER PARKWAY
Practice Address - Street 2:SUITE 207
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2009
Practice Address - Country:US
Practice Address - Phone:301-441-8711
Practice Address - Fax:301-441-4859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
178181Medicare ID - Type Unspecified