Provider Demographics
NPI:1083613467
Name:D'AMATO, LUIGI O (MD)
Entity Type:Individual
Prefix:
First Name:LUIGI
Middle Name:O
Last Name:D'AMATO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3740 W SYLVANIA AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-4461
Mailing Address - Country:US
Mailing Address - Phone:419-473-6622
Mailing Address - Fax:419-473-6627
Practice Address - Street 1:3740 W SYLVANIA AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-4461
Practice Address - Country:US
Practice Address - Phone:419-473-6622
Practice Address - Fax:419-473-6627
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35041551207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH160041504OtherRRMC
OH2083291OtherAETNA
OH000000141249OtherANTHEM
OH07-01478OtherUHC
OH00116OtherPARAMOUNT
OH0429914Medicaid
OH07-01478OtherUHC
OHDA0480274Medicare PIN