Goda P Damera, | |
3128 Wheaton Way, Apt E, Ellicott City, MD 21043 | |
(775) 997-5066 | |
Not Available |
Full Name | Goda P Damera |
---|---|
Gender | Male |
Speciality | Internal Medicine |
Experience | 18 Years |
Location | 3128 Wheaton Way, Ellicott City, Maryland |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1275841595 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 52104 (Tennessee) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Baptist Memorial Hospital | Memphis, TN | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Southeastern Physician Services Pc | 0042307852 | 499 |
Entity Name | Southeastern Physician Services Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1083835441 PECOS PAC ID: 0042307852 Enrollment ID: O20071025000571 |
Mailing Address | Practice Location Address |
---|---|
Goda P Damera, 6019 Walnut Grove Rd, Memphis, TN 38120-2113 Ph: (775) 997-5066 | Goda P Damera, 3128 Wheaton Way, Apt E, Ellicott City, MD 21043 Ph: (775) 997-5066 |
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