Davis, Mark W
Davis, Mark W is an sole proprietor health care provider with primary practice located at 109 North 29Th Street-Suite 1 , Norfolk NE 68701. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Davis, Mark W can be contacted via phone (402) 644-4600.Contact Information
Primary practice address
109 North 29Th Street-Suite 1
Norfolk NE 68701
Phone: (402) 644-4600
Fax: (402) 644-3430
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 17496 | Nebraska |
Profile Details
| NPI number | 1376626416 |
|---|---|
| LBN Legal business name | Davis, Mark W |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 23rd, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1376626416 | NPPES |
| Nebraska | MEDICAID | 10025059200 |
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