Individual
BREA NICOLE DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
720 WESTVIEW DR SW, ATLANTA, GA 30310-1458
(678) 357-6524
Mailing address
4859 STONEHALL PL, ATLANTA, GA 30339-1511
(678) 357-6524
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
94036
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/13/2021
Last updated
01/19/2023
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