Individual
DR. ADELIA MARIE DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
575 RIVERGATE, SUITE 210, DURANGO, CO 81301-7487
(970) 247-0042
(970) 259-8837
Mailing address
23 DELWOOD PL, DURANGO, CO 81301-4875
(970) 259-1875
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25620
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01256205
—
CO
01
—
10404779
CAQH
—
01
—
68587687
TPIN
—
Enumeration date
06/28/2006
Last updated
02/25/2008
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