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Individual

DR. TIMOTHY E. DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
303 S NAPPANEE ST, ELKHART, IN 46514-2066
(574) 296-3955
(574) 296-3999
Mailing address
PO BOX 2968, ELKHART, IN 46515-2968
(574) 296-3955
(574) 296-3999

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01027755A
IN
207QA0401X
Addiction Medicine (Family Medicine) Physician
01027755A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100348240A
IN
Enumeration date
05/24/2005
Last updated
06/09/2009
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