Provider Demographics
NPI:1841499761
Name:DAM, OANH XUAN (MD)
Entity type:Individual
Prefix:DR
First Name:OANH
Middle Name:XUAN
Last Name:DAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4487 JONESBORO RD
Mailing Address - Street 2:
Mailing Address - City:FOREST PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30297-4316
Mailing Address - Country:US
Mailing Address - Phone:404-366-8822
Mailing Address - Fax:404-366-8824
Practice Address - Street 1:4487 JONESBORO RD
Practice Address - Street 2:
Practice Address - City:FOREST PARK
Practice Address - State:GA
Practice Address - Zip Code:30297-4316
Practice Address - Country:US
Practice Address - Phone:404-366-8822
Practice Address - Fax:404-366-8824
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA040894208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000766884AOtherGA BETTER HEALTHCARE
GA000766884AOtherGA PEACHCARE FOR KIDS
GA58-246-4960OtherBEECH STREET NETWORK PPO
GA000766884AMedicaid
GA303256OtherWELLCARE HEALTH PLAN
GA01000556OtherAMERIGROUP
GA103001OtherPEACH STATE HEALTH PLAN
GA000766884AMedicaid
GA000766884AOtherGA PEACHCARE FOR KIDS