Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0004X | Dentist Anesthesiologist | 7270 | NC |
NPI | 1578686796 |
---|---|
Provider Name | Dr. Edward W. Davidian JR. |
First Address | Chapel Hill, NC 27517-5662 |
Second Address | Durham, NC 27713-7512 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2007 |
Last Update Date | 17/05/2013 |