Provider Demographics
NPI:1568722726
Name:BASS, DAMON L (DO)
Entity Type:Individual
Prefix:DR
First Name:DAMON
Middle Name:L
Last Name:BASS
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:108 CANTERBURY LN
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-1278
Mailing Address - Country:US
Mailing Address - Phone:215-317-0735
Mailing Address - Fax:866-385-0476
Practice Address - Street 1:2301 RENAISSANCE BLVD
Practice Address - Street 2:GLAXOSMITHKLINE
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-2772
Practice Address - Country:US
Practice Address - Phone:610-787-3234
Practice Address - Fax:610-787-7043
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-22
Last Update Date:2012-05-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS-009755-L207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology