Individual
WINSTON BROOKS DAVIS
Active
Individual
WINSTON BROOKS DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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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