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Individual

TIMUR DAVYDOV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
458 CARLYLE E, BELLEVILLE, IL 62221-4525
(646) 251-8364
Mailing address
458 CARLYLE E, BELLEVILLE, IL 62221-4525
(646) 251-8364

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
2021019888
MO
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/28/2018
Last updated
12/28/2024
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