Provider Demographics
NPI:1124026760
Name:DAMWEBER, BRIAN J (MPAS PA-C)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:J
Last Name:DAMWEBER
Suffix:
Gender:M
Credentials:MPAS PA-C
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Mailing Address - Street 1:1 E BROAD ST STE 130
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-5934
Mailing Address - Country:US
Mailing Address - Phone:484-626-0480
Mailing Address - Fax:484-896-9002
Practice Address - Street 1:3477 CORPORATE PKWY STE 100
Practice Address - Street 2:
Practice Address - City:CENTER VALLEY
Practice Address - State:PA
Practice Address - Zip Code:18034-8237
Practice Address - Country:US
Practice Address - Phone:484-626-0480
Practice Address - Fax:484-896-9002
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA002758L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAS71279Medicare UPIN