Individual
EDDIE DEAN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
354 COPPERFIELD BLVD NE, CONCORD, NC 28025-2402
(704) 323-2000
Mailing address
4601 PARK RD, SUITE 300, CHARLOTTE, NC 28209-3239
(704) 323-2000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
103716
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C5985
MEDCOST
NC
01
—
P00136713
RAILROAD MEDICARE
—
Enumeration date
10/26/2005
Last updated
06/07/2016
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