Provider Demographics
NPI:1124026760
Name:DAMWEBER, BRIAN J (MPAS PA-C)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:J
Last Name:DAMWEBER
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Gender:M
Credentials:MPAS PA-C
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Mailing Address - Street 1:1605 N CEDAR CREST BLVD STE 110B
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-2351
Mailing Address - Country:US
Mailing Address - Phone:610-973-1410
Mailing Address - Fax:610-973-1442
Practice Address - Street 1:1605 N CEDAR CREST BLVD STE 110B
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-2351
Practice Address - Country:US
Practice Address - Phone:610-973-1410
Practice Address - Fax:610-973-1442
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2021-12-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMA002758L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAS71279Medicare UPIN