Provider Demographics
NPI:1174819130
Name:WESSEL, DAMARIS SUZANNE (DO)
Entity Type:Individual
Prefix:DR
First Name:DAMARIS
Middle Name:SUZANNE
Last Name:WESSEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:933 E HAVERFORD RD
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-3819
Mailing Address - Country:US
Mailing Address - Phone:610-649-6400
Mailing Address - Fax:610-649-7971
Practice Address - Street 1:933 E HAVERFORD RD
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3819
Practice Address - Country:US
Practice Address - Phone:610-649-6400
Practice Address - Fax:610-649-7971
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS016862207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine