Davenport, Mark Wilbur

Davenport, Mark Wilbur is an sole proprietor health care provider with primary practice located at 920 Delbon Ave , Turlock CA 95382-2019. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Critical Care Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Davenport, Mark Wilbur can be contacted via phone (209) 634-7283.

Contact Information

Primary practice address
920 Delbon Ave Turlock CA 95382-2019
Phone: (209) 634-7283
Fax: (209) 634-9167
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X G-31689 California
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X G-31689 California

Profile Details

NPI number 1831129493
LBN Legal business name Davenport, Mark Wilbur
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 3rd, 2006
Last updated Jul 20th, 2011 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831129493 NPPES
California MEDICAID 00G316892
California Other G-31689

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