Individual
DR. MICHAEL LEE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1200 W TABOR RD BLDG SUITE275, PHILADELPHIA, PA 19141-3019
(215) 456-8210
(215) 456-1933
Mailing address
1200 W TABOR RD BLDG SUITE275, PHILADELPHIA, PA 19141-3019
(215) 456-8210
(215) 456-1933
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0T11593
PA
207RG0100X
Gastroenterology Physician
Primary
OS015556
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
232290323
EMPLOYER IDENTIFICATION N
PA
05
—
2C0453
—
PA
Enumeration date
05/17/2007
Last updated
04/25/2022
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