Individual
DR. CARMEN NESSIM DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2600 FERRY ST, LAFAYETTE, IN 47904-3055
(765) 448-8000
(765) 448-7636
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01071211A
IN
208M00000X
Hospitalist Physician
01071211A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000771538
ANTHEM PROVIDER NUMBER
IN
05
—
201070410
—
IN
Enumeration date
03/20/2009
Last updated
07/05/2022
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