Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 044142 | CT |
Y | 208600000X | Surgeon | 044142 | CT |
N | 208200000X | Surgeon | 36097831 | IL |
N | 208600000X | Surgeon | 36097831 | IL |
N | 2086S0102X | Surgical Critical Care | 044142 | CT |
N | 2086S0102X | Surgical Critical Care | 36097831 | IL |
N | 2086S0127X | Trauma Surgeon | 044142 | CT |
NPI | 1306812664 |
---|---|
Provider Name | Dr. Kimberly Davis |
First Address | New Haven, CT 06520-8062 |
Second Address | New Haven, CT 06520-8062 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2006 |
Last Update Date | 09/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G57610 | (02) |