Individual
DAVID R DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1021 MEDICAL CIR, #100, MYRTLE BEACH, SC 29572-4608
(843) 692-1062
Mailing address
PO BOX 4860, MURRELLS INLET, SC 29576-2698
(843) 651-2624
(843) 491-4023
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2255
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AN0581
—
SC
Enumeration date
05/22/2006
Last updated
08/29/2016
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