Shivashankar Damodaran, MD | |
2601 Electric Ave, Port Huron, MI 48060-6587 | |
(810) 216-1094 | |
Not Available |
Full Name | Shivashankar Damodaran |
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Gender | Male |
Speciality | Urology |
Location | 2601 Electric Ave, Port Huron, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1528558277 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208800000X | Urology | 4301508337 (Michigan) | Primary |
Entity Name | Port Huron Physicians Medical Group Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1598141640 PECOS PAC ID: 0840507802 Enrollment ID: O20150923002611 |
Mailing Address | Practice Location Address |
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Shivashankar Damodaran, MD 2601 Electric Ave, Port Huron, MI 48060-6587 Ph: (810) 216-1094 | Shivashankar Damodaran, MD 2601 Electric Ave, Port Huron, MI 48060-6587 Ph: (810) 216-1094 |
Mr. Haider Rahbar, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 1037 Water St, Port Huron, MI 48060 Phone: 810-984-4194 Fax: 810-984-4674 | |
Glenn George Betrus, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 1037 Water St, Suite 1, Port Huron, MI 48060 Phone: 810-984-4194 Fax: 810-984-4674 | |
Marshall Kamer, M.D. Urology Medicare: Not Enrolled in Medicare Practice Location: 1037 Water St, Suite 1, Port Huron, MI 48060 Phone: 810-984-4194 Fax: 810-984-4674 | |
Thomas Allan Coury, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 1037 Water St, Suite 1, Port Huron, MI 48060 Phone: 810-984-4194 Fax: 810-984-4674 |