Organization
MICHAEL S DAVIDOV, MD, INC, PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL S DAVIDOV MD (PRESIDENT)
(253) 815-9595
Entity
Organization
Contact information
Practice address
34509 9TH AVENUE SOUTH, #207, FEDERAL WAY, WA 98003-8709
(253) 815-9595
(253) 815-9797
Mailing address
34509 9TH AVENUE SOUTH, #207, FEDERAL WAY, WA 98003-8709
(253) 815-9595
(253) 815-9797
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD00034406
WA
208D00000X
General Practice Physician
MD00034406
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1113661
—
WA
05
—
7900749
—
WA
01
—
GAB20523
PTAN
WA
Enumeration date
09/24/2010
Last updated
12/16/2010
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