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Individual
DAVID P DAVIS
Active
Individual
DAVID P DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01039458A
IN
207Q00000X
Family Medicine Physician
Primary
036086811
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000079566
ANTHEM BLUE CROSS
IN
01
—
0004400750
AETNA
IL
01
—
006686
HEALTH ALLIANCE
IL
01
—
01225376
BLUE CROSS BLUE SHIELD
IL
01
—
311661293
HEALTH LINK
IL
05
—
311661293001
—
IL
Enumeration date
11/04/2005
Last updated
10/25/2018
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