# DAVIS MEDICAL CLINIC, SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770538100
- **Authorized official:** MARSHA DAVIS MD (PRESIDENT)
- **Authorized official phone:** (262) 242-0700

## Contact information

- **Practice address:** 1516 W MEQUON RD, SUITE 103, MEQUON, WI 53092-3264
- **Practice address phone:** (262) 242-0700
- **Practice address fax:** (262) 242-0710
- **Mailing address:** 1516 W MEQUON RD, SUITE 103, MEQUON, WI 53092-3264
- **Mailing address phone:** (262) 242-0700
- **Mailing address fax:** (262) 242-0710

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/24/2006
- **Last updated:** 08/25/2009