Provider Demographics
NPI:1326007196
Name:DAM, ANH (MD)
Entity Type:Individual
Prefix:
First Name:ANH
Middle Name:
Last Name:DAM
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 1:1601 MILLTOWN RD
Mailing Address - Street 2:SUITE 13
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-4027
Mailing Address - Country:US
Mailing Address - Phone:302-993-2330
Mailing Address - Fax:
Practice Address - Street 1:L6 OMEGA DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2077
Practice Address - Country:US
Practice Address - Phone:302-738-9300
Practice Address - Fax:302-738-3791
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-00064162085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00225774OtherRAILROAD MEDICARE #
DE1000036042Medicaid
P00225774OtherRAILROAD MEDICARE #
DE016912X70Medicare PIN
DE1000036042Medicaid