Individual
TODD WARE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
942 FERN AVE SE, ATLANTA, GA 30315-1813
(770) 298-1516
Mailing address
942 FERN AVE SE, ATLANTA, GA 30315-1813
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036104177
IL
Other
Enumeration date
01/09/2019
Last updated
01/09/2019
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