Provider Demographics
NPI:1588825947
Name:COMBS, DAMON BRENT (DPM)
Entity type:Individual
Prefix:DR
First Name:DAMON
Middle Name:BRENT
Last Name:COMBS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2000 OXFORD DRIVE
Mailing Address - Street 2:SUITE 211
Mailing Address - City:BETHEL
Mailing Address - State:PA
Mailing Address - Zip Code:15102-1827
Mailing Address - Country:US
Mailing Address - Phone:412-283-0260
Mailing Address - Fax:412-283-0070
Practice Address - Street 1:2000 OXFORD DRIVE
Practice Address - Street 2:SUITE 211
Practice Address - City:BETHEL PARK
Practice Address - State:PA
Practice Address - Zip Code:15102-1827
Practice Address - Country:US
Practice Address - Phone:412-283-0260
Practice Address - Fax:412-283-0070
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-18
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASC005880213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1024513260001Medicaid