Individual
CORDULA FAYE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5929 SOUTH BLVD, CHARLOTTE, NC 28217-4123
(704) 667-5160
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2010-01668
NC
208000000X
Pediatrics Physician
2010-01668
NC
208D00000X
General Practice Physician
2010-01668
NC
Other
Enumeration date
05/11/2009
Last updated
07/17/2024
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