Provider Demographics
NPI:1811289937
Name:AVRAMIDIS, DAMIANOS G (PHARMD)
Entity type:Individual
Prefix:
First Name:DAMIANOS
Middle Name:G
Last Name:AVRAMIDIS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MONSON
Mailing Address - State:MA
Mailing Address - Zip Code:01057-1320
Mailing Address - Country:US
Mailing Address - Phone:413-267-4021
Mailing Address - Fax:
Practice Address - Street 1:117 MAIN ST
Practice Address - Street 2:
Practice Address - City:MONSON
Practice Address - State:MA
Practice Address - Zip Code:01057-1320
Practice Address - Country:US
Practice Address - Phone:413-267-4021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-08
Last Update Date:2011-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH27462183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist