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Individual

DR. MATTHEW L DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2500 NILES ROAD, SUITE #7, ST. JOSEPH, MI 49085
(269) 982-7844
(269) 982-1783
Mailing address
2500 NILES ROAD, SUITE #7, ST JOSEPH, MI 48085
(269) 982-7844
(269) 982-1783

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4301084762
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4301084762
STATE LISCENSE
MI
Enumeration date
06/22/2006
Last updated
01/25/2011
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