Provider Demographics
NPI:1174634711
Name:DAMAST, MELVYN (MD)
Entity Type:Individual
Prefix:DR
First Name:MELVYN
Middle Name:
Last Name:DAMAST
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 1:19 HAMPTON RD
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-4816
Mailing Address - Country:US
Mailing Address - Phone:603-772-3456
Mailing Address - Fax:603-772-4912
Practice Address - Street 1:19 HAMPTON RD
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-4816
Practice Address - Country:US
Practice Address - Phone:603-772-3456
Practice Address - Fax:603-772-4912
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNH7538207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0242060001Medicare NSC