Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208800000X | Urologist | 0101356295 | VA |
N | 208800000X | Urologist | 55211-020 | WI |
N | 208800000X | Urologist | D0077852 | MD |
Y | 208800000X | Urologist | MD042533 | DC |
NPI | 1023250685 |
---|---|
Provider Name | Tanya Dzintra Davis |
First Address | Washington, DC 20010-2916 |
Second Address | Washington, DC 20010-2916 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2009 |
Last Update Date | 08/02/2022 |