Provider Demographics
NPI:1740362607
Name:D'AMICO, ANNA MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:MARIE
Last Name:D'AMICO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2106 SILVERSIDE RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-4162
Mailing Address - Country:US
Mailing Address - Phone:302-477-9660
Mailing Address - Fax:
Practice Address - Street 1:2106 SILVERSIDE RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4162
Practice Address - Country:US
Practice Address - Phone:302-477-9660
Practice Address - Fax:302-477-9495
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD014746E207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEB66516Medicare UPIN
DE141135Medicare ID - Type Unspecified