Individual
DIANE MARIE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1313 HALLEY ST, LYON PARK CLINIC, DURHAM, NC 27707-1227
(919) 536-4205
Mailing address
6519 TURKEY RUN W, MEBANE, NC 27302-8652
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
101982
NC
Other
Enumeration date
07/06/2006
Last updated
08/30/2022
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