Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | MD4085 | DC |
N | 2084N0402X | Child Neurologist | MD4085 | DC |
NPI | 1609949254 |
---|---|
Provider Name | Miryam M Davis |
First Address | Bethesda, MD 20817-4752 |
Second Address | Washington, DC 20010-2927 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2006 |
Last Update Date | 12/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
022868200 | (05) | DC |
C88585 | (02) | DC |