Individual
GWEN K DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1000 JOHNSON FERRY RD NE, ATLANTA, GA 30342-1606
(770) 645-9181
(770) 645-8455
Mailing address
3155 N POINT PKWY, ATTN: CREDENTIALING DEPT., BUILDING F SUITE 100, ALPHARETTA, GA 30005
(770) 645-9181
(770) 645-8455
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
30042
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000429415B
—
GA
05
—
000429415C
—
GA
05
—
000429415D
—
GA
Enumeration date
09/26/2005
Last updated
08/26/2013
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