Individual
BRADLEY DUANE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
101 E WOOD ST, EMERGENCY CENTER, SPARTANBURG, SC 29303-3040
(864) 560-6222
(864) 560-4413
Mailing address
1 INDEPENDENCE PT STE 212, GREENVILLE, SC 29615-4536
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
845
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008459
—
SC
01
—
189202
MEDCOST
SC
01
—
20030852
SELECT HEALTH OF SC
SC
01
—
7361552
AETNA
SC
05
—
89067H3
—
NC
Enumeration date
01/17/2006
Last updated
12/17/2020
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