Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 15213 | NH |
NPI | 1164697264 |
---|---|
Provider Name | Dr. Alexander David Davis |
First Address | Exeter, NH 03833-4848 |
Second Address | Exeter, NH 03833-4848 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2008 |
Last Update Date | 05/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3076292 | (05) | NH |