Individual
JULIO G DAVALOS
Active
Individual
JULIO G DAVALOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
21678
WV
208800000X
Urology Physician
Primary
D72502
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
043860000
—
MD
01
—
E279/0107
BLUE CHOICE
MD
Enumeration date
10/21/2006
Last updated
04/25/2014
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