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Individual
DEAN ELDON DAVIS
Active
Individual
DEAN ELDON DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
13797
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137970
—
SC
01
—
195789
MEDCOST
SC
01
—
4263370
AETNA
SC
05
—
790557R
—
NC
01
—
AA53843365
MEDICARE PIN
SC
Enumeration date
01/25/2006
Last updated
12/17/2020
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