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NPI Code Detail

MEDICARE: DR. DAVID A. DAVIS M.D.

MEDICARE: DR. DAVID A. DAVIS M.D.
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
1207N00000XDermatology Physician2000-174NM
2207ND0101XMOHS-Micrographic Surgery Physician32332IA
3207ND0101XMOHS-Micrographic Surgery Physician2000-174NM

General Provider Information

NPI Number : 1124024880
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID A. DAVIS M.D.
Provider Business Mailing Address
First Line : 800 BRADBURY DR SE STE 116
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87106-4310
Country : US
Telephone Number : 52-721-4765
Fax Number :
Provider Business Practice Location Address
First Line : 5120 MASTHEAD ST NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87109-4366
Country : US
Telephone Number : 505-243-7546
Fax Number : 505-243-7547
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2005
Last Update Date : 02/06/2025

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Directions to “ DR. DAVID A. DAVIS M.D.” Practice Location

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