Individual
MARC J DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
451 BISHOP FEDERAL LANE, SALT LAKE CITY, UT 84115
(801) 288-0747
Mailing address
555 E 4500 S, C150, SALT LAKE CITY, UT 84107
(801) 288-0747
(801) 288-0761
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
1887751205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
260043378
MED RR
UT
Enumeration date
08/16/2006
Last updated
08/07/2008
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