Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | 152583 | MA |
NPI | 1558468165 |
---|---|
Provider Name | David P Regis |
First Address | Apo, AE 09494-0004 |
Second Address | Apo, AE 09461-5115 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2006 |
Last Update Date | 02/12/2015 |