Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | D37807 | MD |
NPI | 1013902600 |
---|---|
Provider Name | Dr. Alvin William Davis |
First Address | Cumberland, MD 21502-2717 |
Second Address | Cumberland, MD 21502-3765 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E63331 | (02) | MD |