Individual
DR. PHILIP A DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MEDICAL DOCTOR
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
ME54865
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18987
BLUE CROSS BLUE SHIELD
FL
01
—
2000016351
RAILROAD MEDICARE
FL
05
—
373524900
—
FL
01
—
4511587
AETNA
FL
01
—
AVMED
258113
FL
Enumeration date
11/17/2005
Last updated
10/01/2012
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