Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | BP10036857 | TX |
N | 208600000X | Surgeon | BP10036857 | TX |
Y | 2086S0129X | Vascular Surgeon | 58744 | MN |
NPI | 1053632323 |
---|---|
Provider Name | Dr. James Adam Davis |
First Address | Minneapolis, MN 55407-1321 |
Second Address | Saint Paul, MN 55102-2533 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2010 |
Last Update Date | 11/03/2021 |