Individual
DERRICK DAVIS SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
18286 BOXELDER DR, BROWNSTOWN, MI 48174-9261
(734) 229-1514
Mailing address
18286 BOXELDER DR, BROWNSTOWN, MI 48174-9261
(734) 229-1514
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704235173
MI
Other
Enumeration date
06/23/2015
Last updated
06/23/2015
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