Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | OS 2964-L | PA |
Y | 207Q00000X | Family Doctor | OS 2964-L | PA |
NPI | 1104084862 |
---|---|
Provider Name | Dr. David John Davis II |
First Address | New Hope, PA 18938-9307 |
Second Address | New Hope, PA 18938 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2008 |
Last Update Date | 29/05/2008 |