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Individual

LEO WARREN DAVIDSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1841 QUIET CV, FAYETTEVILLE, NC 28304-3985
(910) 829-6588
(910) 829-6596
Mailing address
1841 QUIET CV, P O BOX 64367, FAYETTEVILLE, NC 28304-3985
(910) 323-2626
(910) 829-6596

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
35312
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
020031637
MEDICARE RAIL ROAD
NC
01
1738882
UNITED HEALTH CARE
NC
01
27271
BLUE CROSS BLUE SHIELD
NC
01
47806
MED COST
NC
05
8927271
NC
Enumeration date
09/21/2005
Last updated
02/18/2010
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