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General NPI Number Information
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NPI Number | 1154483428
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Entity Type | Individual
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Provider Name | JOALIE EMMANUELLE DAVIE M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 05/14/2010
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Provider Practice Location Address
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Address Line | 932 CAMINO DON EMILIO
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City | SANTA FE
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State | NM
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Zip | 87507-7684
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Country | US
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Telephone | 505-819-9717
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Fax |
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Provider Business Mailing Address
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Address Line | 932 CAMINO DON EMILIO
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City | SANTA FE
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State | NM
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Zip | 87507-7684
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Country | US
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Telephone | 505-819-9717
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 52411
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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