Individual
MICHAEL DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12010 SHELBYVILLE RD, SUITE 400, LOUISVILLE, KY 40243-1054
(502) 897-9191
(502) 897-7626
Mailing address
PO BOX 950248, LOUISVILLE, KY 40295-0248
(502) 489-5730
(502) 489-5733
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
26497
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000500017
ANTHEM
KY
05
—
6426497100
—
KY
Enumeration date
06/20/2006
Last updated
12/03/2020
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