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:
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Health care specialties

SpecialtyCodeLicense #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 2 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 1962488288 NPPES
Georgia MEDICAID 00868612C
Georgia MEDICAID 000868612B
Georgia MEDICAID G40257

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