Provider Demographics
NPI:1700094794
Name:DAVIS MARTE, NOEMI (MD)
Entity type:Individual
Prefix:MRS
First Name:NOEMI
Middle Name:
Last Name:DAVIS MARTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8488
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-8488
Mailing Address - Country:US
Mailing Address - Phone:787-743-4426
Mailing Address - Fax:787-743-4426
Practice Address - Street 1:D7 AVE DEGETAU
Practice Address - Street 2:SAN ALFONSO
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-5838
Practice Address - Country:US
Practice Address - Phone:787-743-4426
Practice Address - Fax:787-743-4426
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR005226261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care