Individual
DR. MARK L DAVIS
Active
Individual
DR. MARK L DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
007480
AZ
207X00000X
Orthopaedic Surgery Physician
5101012747
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200000001852
PHYSICIANS HEALTH PLAN
MI
01
—
200C313650
BCBS MI
MI
01
—
200C31650
BLUECARE NETWORK
MI
01
—
2053302675
BLUE SHIELD
MI
01
—
300040412
TRICARE
MI
05
—
4837808
—
MI
Enumeration date
06/10/2005
Last updated
04/11/2022
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