Individual
MR. MICHAEL ELVIS DAVISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1900 EXETER RD, SUITE 210, GERMANTOWN, TN 38138-2954
(901) 818-2160
(901) 682-9522
Mailing address
1900 EXETER RD, SUITE 210, GERMANTOWN, TN 38138-2954
(901) 818-2160
(901) 682-9522
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R54101
AR
367500000X
Certified Registered Nurse Anesthetist
Primary
APN 15003
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09304510
—
MS
05
—
1520341
—
TN
01
—
4264006
BLUE CROSS
TN
01
—
P00907127
RAILROAD MEDICARE
TN
Enumeration date
03/12/2010
Last updated
06/09/2011
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