Individual
MARIANNE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
401 MAIN ST STE 1, JOHNSON CITY, NY 13790-2065
(607) 754-9870
(607) 785-9862
Mailing address
401 MAIN ST, STE 1, JOHNSON CITY, NY 13790-2065
(607) 754-9870
(607) 785-9862
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
265514-1
NY
207VX0000X
Obstetrics Physician
265514-1
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3487189
—
NY
Enumeration date
03/11/2007
Last updated
03/17/2018
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