Davis, Wendy
Davis, Wendy is an individual health care provider with primary practice located at 105 Mills Ave Ste 200 , Las Vegas NM 87701-4169. She recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as her primary health care specialty. Davis, Wendy can be contacted via phone (505) 426-3795.Contact Information
Primary practice address
105 Mills Ave Ste 200
Las Vegas NM 87701-4169
Phone: (505) 426-3795
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 042057 | Georgia |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | MD2016-0938 | New Mexico |
Profile Details
| NPI number | 1962488288 |
|---|---|
| LBN Legal business name | Davis, Wendy |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 19th, 2005 |
| Last updated | Jun 13th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962488288 | NPPES |
| Georgia | MEDICAID | 00868612C | |
| Georgia | MEDICAID | 000868612B | |
| Georgia | MEDICAID | G40257 |
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