Provider Demographics
NPI:1326099607
Name:DAMBA, VICTORIA A (DO)
Entity type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:A
Last Name:DAMBA
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:1508 EDGEMONT BLVD
Mailing Address - Street 2:
Mailing Address - City:PERRYVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63775-1231
Mailing Address - Country:US
Mailing Address - Phone:573-768-3220
Mailing Address - Fax:573-519-5330
Practice Address - Street 1:1508 EDGEMONT BLVD
Practice Address - Street 2:
Practice Address - City:PERRYVILLE
Practice Address - State:MO
Practice Address - Zip Code:63775-1231
Practice Address - Country:US
Practice Address - Phone:573-768-3220
Practice Address - Fax:573-519-5330
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2025-01-16
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Provider Licenses
StateLicense IDTaxonomies
MO113379207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H20017Medicare UPIN