Provider Demographics
NPI:1063747178
Name:MCCLAIN, DAMON M (MD)
Entity type:Individual
Prefix:DR
First Name:DAMON
Middle Name:M
Last Name:MCCLAIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:980 BEAVER GRADE RD
Mailing Address - Street 2:SUITE 10A
Mailing Address - City:CORAOPOLIS
Mailing Address - State:PA
Mailing Address - Zip Code:15108-2774
Mailing Address - Country:US
Mailing Address - Phone:412-262-4911
Mailing Address - Fax:412-262-7856
Practice Address - Street 1:980 BEAVER GRADE RD
Practice Address - Street 2:SUITE 10A
Practice Address - City:CORAOPOLIS
Practice Address - State:PA
Practice Address - Zip Code:15108-2774
Practice Address - Country:US
Practice Address - Phone:412-262-4911
Practice Address - Fax:412-262-7856
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-07
Last Update Date:2015-06-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC2012-01176207N00000X
PAMD453980207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNC9890AOtherMEDICARE NUMBER