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1366539413

NPI Code Detail

MEDICARE: DANIEL ALYN DAVIS MD

MEDICARE: DANIEL ALYN DAVIS MD

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
1	207ND0101X	MOHS-Micrographic Surgery Physician	MD-2011-0809	NM

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00052697	OTHER	AR	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366539413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL ALYN DAVIS MD

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	:	505-272-1476
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	:	505-948-8975
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/09/2006
Last Update Date	:	02/06/2025

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Directions to “ DANIEL ALYN DAVIS MD” Practice Location

Language	Start Address	Practice Location

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