Individual
JOEL R DAVEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1813 W HARVARD AVE, SUITE 206, ROSEBURG, OR 97470-2752
(541) 677-3466
(541) 672-1324
Mailing address
1813 W HARVARD AVE, SUITE 206, ROSEBURG, OR 97470-2752
(541) 677-3466
(541) 672-1324
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
MD16514
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007216
—
OR
Enumeration date
02/20/2007
Last updated
07/08/2007
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