Provider Demographics
NPI:1356315261
Name:TELL, DAMILYTA L (MD)
Entity type:Individual
Prefix:
First Name:DAMILYTA
Middle Name:L
Last Name:TELL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:34900 CHARDON RD
Mailing Address - Street 2:SUITE #107
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-9161
Mailing Address - Country:US
Mailing Address - Phone:440-951-5600
Mailing Address - Fax:440-951-1293
Practice Address - Street 1:34900 CHARDON RD
Practice Address - Street 2:SUITE #107
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-9161
Practice Address - Country:US
Practice Address - Phone:440-951-5600
Practice Address - Fax:440-951-1293
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-15
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
OH852192084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry