Individual
DR. ELIZABETH ANN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2323 N LAKE DR, ATTN: SACRED HEART REHAB, MILWAUKEE, WI 53211-4508
(414) 298-6735
(414) 298-6737
Mailing address
4425 N PORT WASHINGTON RD, ATTN: CSMCP CLINIC CREDENTIALING, GLENDALE, WI 53212-1082
(414) 298-6735
(414) 298-6737
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
36413-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30688400
—
WI
Enumeration date
06/09/2006
Last updated
06/11/2012
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