Individual
DONALD E DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1230 E MAIN ST, MANKATO CLINIC AT MAIN STREET, MANKATO, MN 56002-8674
(507) 625-1811
Mailing address
PO BOX 8674, MANKATO CLINIC LTD 1230 E. MAIN STREET, MANKATO, MN 56002-8674
(507) 625-1811
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
34461
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0301642
MEDICA
MN
01
—
070007599
RR MEDICARE
—
01
—
115538
U CARE
MN
01
—
410849339 56001 C100
CHAMPUS
—
01
—
4T624DA
BC BS
MN
01
—
882331
AMERICAS PPO
MN
05
—
937813
—
IA
05
—
984325600
—
MN
01
—
HP25594
HEALTH PARTNERS
MN
01
—
NA2951023824
PREFERRED ONE
MN
Enumeration date
01/10/2006
Last updated
07/10/2020
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