Individual
SCOTT DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
111 S 11TH ST, SUITE 8490, PHILADELPHIA, PA 19107-4824
(215) 955-6161
(215) 923-5507
Mailing address
111 S 11TH ST, SUITE 8490, PHILADELPHIA, PA 19107-4824
(215) 955-6161
(215) 923-5507
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD454523
PA
207R00000X
Internal Medicine Physician
MT199752
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103039057 0001
—
PA
05
—
103039057 0002
—
PA
Enumeration date
06/27/2011
Last updated
11/03/2015
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