Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 173462 | NY |
Y | 208600000X | Surgeon | 173462 | NY |
N | 2082S0105X | Plastic Hand Surgeon | 173462 | NY |
NPI | 1841217387 |
---|---|
Provider Name | Dr. Mark S. Davenport |
First Address | Rochester, NY 14625-2660 |
Second Address | Rochester, NY 14625-2660 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 29/12/2009 |