Individual
ELLIOT B DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 WABASH AVE, #301, AKRON, OH 44307-2433
(330) 344-6047
(330) 344-6042
Mailing address
400 WABASH AVE, #301, AKRON, OH 44307-2433
(330) 344-6047
(330) 344-6042
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35049124
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0290886
MEDICAID GROUP #
OH
05
—
0542167
—
OH
01
—
1821035940
AGMC TYPE 2 NPI #
OH
01
—
1841239274
PARTNERS PHYSICIAN GROUP TYPE 2 NPI #
OH
01
—
3600271
MEDICARE GROUP #
OH
Enumeration date
08/23/2006
Last updated
01/18/2013
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