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Individual

DR. ANDREW M. DAVIDOFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
262 DANNY THOMAS PLACE, MS 0515, ST. JUDE CHILDREN'S RESEARCH HOSPITAL, MEMPHIS, TN 38105-3678
(901) 595-3006
(901) 595-3842
Mailing address
262 DANNY THOMAS PLACE, MS 0515, ST. JUDE CHILDREN'S RESEARCH HOSPITAL, MEMPHIS, TN 38105-3678
(901) 595-3006
(901) 595-3842

Taxonomy

Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
29260
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00118708
MS
05
009914190
AL
05
0149566
MT
05
036093610-3
IL
05
0527846
IA
05
100016910A
OK
05
104802025
MI
05
133131001
AR
05
1549606
LA
05
200110730A
IN
05
200377030A
KS
05
2033963
OH
05
205026701
MO
05
3818503
TN
05
422400000
ME
05
64927858
KY
05
6514201
NJ
05
7612100
NC
Enumeration date
05/23/2005
Last updated
04/05/2011
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