Provider Demographics
NPI:1225197312
Name:STUTES, DAMON LEMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:DAMON
Middle Name:LEMAR
Last Name:STUTES
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 1:5915 TYRONE RD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-6262
Mailing Address - Country:US
Mailing Address - Phone:775-827-0616
Mailing Address - Fax:
Practice Address - Street 1:5915 TYRONE RD
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-6262
Practice Address - Country:US
Practice Address - Phone:775-827-0616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5561207VG0400X
CAA31179207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology