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Individual

SHELDON LEONARD DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
226 S WOODS MILL RD STE 48W, CHESTERFIELD, MO 63017-3663
(314) 576-7503
(314) 576-2150
Mailing address
226 S WOODS MILL RD STE 48W, CHESTERFIELD, MO 63017-3663
(314) 576-7503
(314) 576-2150

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
R5753
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05556
BLUE CROSS BLUE SHIELD
MO
05
201334901
MO
Enumeration date
10/04/2006
Last updated
04/12/2018
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