Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | MD428689 | PA |
Y | 207L00000X | Anesthesiologist | ME146198 | FL |
NPI | 1013940212 |
---|---|
Provider Name | Dr. Dusan Damjanovic |
First Address | Danville, PA 17822-4903 |
Second Address | Danville, PA 17822-2025 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2006 |
Last Update Date | 15/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101661202 | (05) | PA |
103168 | GEISINGER-GH (01) | PA |
1554147 | GATEWAY-GH (01) | PA |
1872495 | HIGHMARK BLUE SHIELD-GH (01) | PA |
20054402 | AMERIHEALTH MERCY-GH (01) | PA |
2732264000 | AMERIHEALTH 65 PA-GH (01) | PA |
50067113 | CAPITAL BLUE CROSS-GH (01) | PA |
I56198 | (02) |