Individual
LUCY GREEN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
899 ISLAND PARK DR, STE 200, DANIEL ISLAND, SC 29492-8112
(843) 856-6402
(843) 216-5068
Mailing address
PO BOX 530062, ATLANTA, GA 30353-0062
(843) 695-6071
(843) 569-5879
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23608
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
236088
—
SC
01
—
P00023765
MEDICARE RAIL ROAD
SC
Enumeration date
04/27/2006
Last updated
07/06/2021
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