| NPI | 1801010145 |
|---|---|
| Former Legal Business Name | ALONZO JAMES DAVIS IV MD PHD PC |
| Entity Type | Organization |
| Authorized Contact | LARRY JOE MATURANI Md/Owner 570-417-2146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 9401169) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2024-10-11 |