Provider Demographics
NPI:1841383734
Name:DAMON, STUART N (DO)
Entity Type:Individual
Prefix:
First Name:STUART
Middle Name:N
Last Name:DAMON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 MIDDLE RD
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-1227
Mailing Address - Country:US
Mailing Address - Phone:207-956-2149
Mailing Address - Fax:
Practice Address - Street 1:185 TOWNSEND AVE
Practice Address - Street 2:
Practice Address - City:BOOTHBAY HARBOR
Practice Address - State:ME
Practice Address - Zip Code:04538-1894
Practice Address - Country:US
Practice Address - Phone:207-633-1075
Practice Address - Fax:877-492-1491
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1855207P00000X
MEDO1855207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEI28838Medicare UPIN