Individual
MICHAEL PRENTICE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2005 VETERANS MEMORIAL BLVD FL 6, METAIRIE, LA 70002-6320
(504) 836-9820
(504) 846-9608
Mailing address
1514 JEFFERSON HWY, HOSPITALIST GROVE, NEW ORLEANS, LA 70121-2429
(504) 349-1656
(504) 349-1933
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
025236
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03901261
—
MS
05
—
1140368
—
LA
Enumeration date
08/24/2005
Last updated
07/21/2022
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