Provider Demographics
NPI:1508866534
Name:DAMICO, FRANK CHARLES (MD)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:CHARLES
Last Name:DAMICO
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 1:815 SIR THOMAS CT STE 200
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-4839
Mailing Address - Country:US
Mailing Address - Phone:717-724-0720
Mailing Address - Fax:717-724-0730
Practice Address - Street 1:815 SIR THOMAS CT STE 200
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-4839
Practice Address - Country:US
Practice Address - Phone:717-724-0720
Practice Address - Fax:717-724-0730
Is Sole Proprietor?:No
Enumeration Date:2005-08-01
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD042343L208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01018901OtherCAPITAL BLUE CROSS
4603161OtherAETNA
PA01018901OtherCAPITAL BLUE CROSS
4603161OtherAETNA