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Individual

DR. HORACE J DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O

Contact information

Practice address
25373 VAN DYKE AVE, CENTER LINE, MI 48015-1425
(586) 261-2500
Mailing address
25373 VAN DYKE AVE, CENTER LINE, MI 48015-1425
(586) 261-2500

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
5101007157
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
06617A
CALHOUN HEALTH PLAN
MI
01
0851338774
BCBS
MI
05
1917979
MI
01
200000004050
PHYSICIAN HEALTH PLAN
MI
Enumeration date
08/03/2006
Last updated
11/24/2015
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