Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 046122 | VA |
NPI | 1316925167 |
---|---|
Provider Name | Lance Davlin |
First Address | Norfolk, VA 23502-2851 |
Second Address | Norfolk, VA 23502-2851 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2006 |
Last Update Date | 31/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
006405771 | (05) | VA |
400000649 | RAILROAD MEDICARE (01) | |
C00102 | MEDICARE GROUP LEGACY NUM (01) | |
CC7688 | RAILROAD MEDICARE GROUP# (01) | |
F82883 | (02) |