Individual
MICHAEL DAVIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1585 3RD ST, FORT POLK, LA 71459-5102
(337) 531-3517
Mailing address
1776 POLK ST APT 1917, HOLLYWOOD, FL 33020-4776
(210) 819-9648
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1041591
—
Other
Enumeration date
01/10/2007
Last updated
05/12/2021
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