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Individual

MARK A DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
2611 FOREST DR STE 200, COLUMBIA, SC 29204-2371
(803) 779-3263
(803) 779-3207
Mailing address
2611 FOREST DR STE 200, COLUMBIA, SC 29204-2371
(803) 779-3263
(803) 779-3207

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2841
SC

Other

Enumeration date
02/09/2006
Last updated
04/20/2018
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