Individual
DR. PAUL K DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 BRACE ROAD, SUITE C, CHERRY HILL, NJ 08034
(856) 470-9029
(856) 796-9391
Mailing address
500 GROOVE STREET, SUITE 100, HADDON HEIGHTS, NJ 08035
(856) 796-9200
(856) 796-9397
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
C1-0006563
DE
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
25MA09009800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000016774
—
DE
01
—
182454
COVENTRY
—
01
—
E42406
BLUE SHIELD DE
—
Enumeration date
01/26/2006
Last updated
06/21/2013
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