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Organization
ELM MEDICAL, PC
Active
Organization
ELM MEDICAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GORDON CHARLES DAVIS D.O. (PRESIDENT)
(718) 253-3322
Entity
Organization
Contact information
Practice address
1723 ELM AVE, BROOKLYN, NY 11230-5306
(718) 253-3322
(718) 258-6494
Mailing address
1723 ELM AVE, BROOKLYN, NY 11230-5306
(718) 253-3322
(718) 258-6494
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
171745-1
NY
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
171745-1
NY
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2085B0100X
Body Imaging Physician
—
NULL
2085B0100X
Body Imaging Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
NULL
2085R0202X
Diagnostic Radiology Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
NULL
2085U0001X
Diagnostic Ultrasound Physician
—
—
208D00000X
General Practice Physician
—
NULL
208D00000X
General Practice Physician
—
—
Other
Enumeration date
09/09/2008
Last updated
09/09/2008
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