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NPI Code Detail

MEDICARE: DENNIS W DAVIS IDC

MEDICARE:   DENNIS W DAVIS  IDC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171000000XMilitary Health Care Provider

General Provider Information

NPI Number : 1053591313
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENNIS W DAVIS IDC
Provider Business Mailing Address
First Line : USS BUFFALO (SSN 715)
Second Line :
City : FPO
State : AP
Zip : 96661
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : USS BUFFALO (SSN 715)
Second Line : COMNAVMARIANAS
City : SANTA RITA
State : GU
Zip : 96915
Country : US
Telephone Number : 671-564-3022
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2007
Last Update Date : 04/20/2008

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Directions to “ DENNIS W DAVIS IDC” Practice Location

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