Provider Demographics
NPI:1407874605
Name:DELL'AGLIO, DAMON M (MD)
Entity Type:Individual
Prefix:
First Name:DAMON
Middle Name:M
Last Name:DELL'AGLIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:531 ASBURY CIRCLE-ANNEX
Mailing Address - Street 2:SUITE N340
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-0001
Mailing Address - Country:US
Mailing Address - Phone:404-778-5975
Mailing Address - Fax:404-778-2630
Practice Address - Street 1:550 PEACHTREE ST NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2247
Practice Address - Country:US
Practice Address - Phone:404-686-3845
Practice Address - Fax:404-686-4332
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA55940207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine