Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | VA0101034211 | VA |
NPI | 1184622482 |
---|---|
Provider Name | Dr. Daniel Nelson Davidow |
First Address | Richmond, VA 23229-7431 |
Second Address | New Kent, VA 23124-2029 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2005 |
Last Update Date | 26/10/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D98522 | (02) | VA |