Individual
MATTHEW EDWIN DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
33 UPPER RIVERDALE RD SW, SUITE 117, RIVERDALE, GA 30274-2626
(770) 991-1170
(770) 991-0107
Mailing address
33 UPPER RIVERDALE RD SW, SUITE 117, RIVERDALE, GA 30274-2626
(770) 991-1170
(770) 991-0107
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
016052
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00065403B
—
GA
Enumeration date
11/30/2006
Last updated
07/08/2007
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