Individual
DR. FIDENCIO HERNAN DAVALOS
Active
Individual
DR. FIDENCIO HERNAN DAVALOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD2017-0687
NM
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
287474
NY
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
322076
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2528696
—
LA
01
—
MD.322076
STATE MEDICAL LICENSE
LA
Enumeration date
06/28/2013
Last updated
03/16/2022
Update your record
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