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Individual

DR. GARY DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5201 HAVERFORD AVE, PHILADELPHIA, PA 19139
(215) 471-2761
Mailing address
5201 HAVERFORD AVE, PHILADELPHIA, PA 19139-1401
(215) 471-2761

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD072320L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
101524553
PA
Enumeration date
07/18/2006
Last updated
06/11/2019
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