# VIJAYSELWYN DAVIS DHAS MD

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- **Entity:** Organization
- **Status:** Active
- **Other names:** OB-GYN OF ST AUGUSTINE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053614305
- **Authorized official:** VIHAYSELWYN DAVIS DHAS MD (OWNER)
- **Authorized official phone:** (904) 824-9444

## Contact information

- **Practice address:** 301 HEALTH PARK BLVD, STE 219, ST AUGUSTINE, FL 32086-5793
- **Practice address phone:** (904) 824-9444
- **Practice address fax:** (904) 819-9594
- **Mailing address:** PO BOX 840262, ST AUGUSTINE, FL 32080-0262
- **Mailing address phone:** (904) 824-9444

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | ME104834 | FL | Yes |

## Other

- **Enumeration date:** 12/08/2010
- **Last updated:** 10/18/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 002960100 | — | FL |