Individual
WINSTON BROOKS DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
714 N SENATE AVE, STE EF205, INDIANAPOLIS, IN 46202-3763
(317) 715-6402
(317) 715-6415
Mailing address
714 N SENATE AVE, STE EF205, INDIANAPOLIS, IN 46202-3763
(317) 715-6402
(317) 715-6415
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01050878A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200128460
—
IN
01
—
959090AAA6
MEDICARE PTAN
IN
01
—
P00163349
RR MEDICARE
IN
01
—
P00264111
RAILROAD MEDICARE
IN
01
—
P00733995
RAILROAD MEDICARE
IN
01
—
P00800396
RAILROAD MEDICARE
IN
Enumeration date
05/02/2006
Last updated
04/03/2024
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