Individual
DR. MICHAEL ANTHONY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 W ARBOR DR, MAIL CODE: 0834, SAN DIEGO, CA 92103-9000
(619) 543-7636
(619) 543-7898
Mailing address
200 W ARBOR DR, MAIL CODE: 0834, SAN DIEGO, CA 92103-9000
(619) 543-7636
(619) 543-7898
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
Q8459
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
358794101
—
TX
01
—
358794102
CSHCN
TX
Enumeration date
07/14/2010
Last updated
08/08/2016
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