Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 0101256478 | VA |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 059399 | GA |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 25MA04977800 | NJ |
NPI | 1033196415 |
---|---|
Provider Name | William Donald Davidson |
First Address | Fishersville, VA 22939-0388 |
Second Address | Fishersville, VA 22939-2273 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2005 |
Last Update Date | 05/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
178202 | (05) | NJ |
D20037 | (02) |