Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 35.134895 | OH |
N | 111NI0900X | Internist | 35.134895 | OH |
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | 01062747A | IN |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 35.134895 | OH |
NPI | 1093920514 |
---|---|
Provider Name | Dr. Richard P Davis |
First Address | Beavercreek, OH 45431-3834 |
Second Address | Beavercreek, OH 45431-3834 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2007 |
Last Update Date | 03/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0358463 | (05) | OH |