Individual
DR. MICHAEL J DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO, MPH
Contact information
Practice address
2231 CAREW ST, FORT WAYNE, IN 46805-4713
(260) 373-9935
(260) 373-9926
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
02007120A
IN
390200000X
Student in an Organized Health Care Education/Training Program
32002
MN
Other
Enumeration date
06/18/2018
Last updated
08/30/2023
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