Individual
KEITH DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
2433 BLACK RIVER ST, DECKERVILLE, MI 48427-9425
(810) 376-2885
Mailing address
PO BOX 126, 3532 MAIN STREET, DECKERVILLE, MI 48427-0126
(810) 376-3100
(810) 376-8311
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704274292
MI
Other
Enumeration date
07/24/2015
Last updated
11/16/2022
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