Individual
HARRIET NEELY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5815 BLAKENEY PARK DR STE 200B, CHARLOTTE, NC 28277-5734
(704) 316-5080
(704) 316-5085
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101234595
VA
207Q00000X
Family Medicine Physician
Primary
200201452
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005646928
—
VA
05
—
1659346955
—
NC
05
—
5907115
—
NC
05
—
NC2582
—
SC
Enumeration date
02/21/2006
Last updated
09/08/2021
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