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Individual

AMANDA S DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2000 E GREENVILLE ST, SUITE 3700, ANDERSON, SC 29621-1580
(864) 512-1475
(864) 512-1930
Mailing address
2000 E GREENVILLE ST, SUITE 3700, ANDERSON, SC 29621-1580
(864) 512-1475
(864) 512-1930

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
32866
SC
390200000X
Student in an Organized Health Care Education/Training Program
MT190771
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
328666
SC
01
P00963295
RR MEDICARE
SC
Enumeration date
05/15/2007
Last updated
05/20/2014
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