Individual
SAMUEL M. DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4102 PINION DR, SUITE 100, USAF ACADEMY, CO 80840-2502
(719) 333-5005
Mailing address
277 ALL SKY DR, COLORADO SPRINGS, CO 80921-2886
(937) 974-3407
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35-085824
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000371925
BLUECROSS BLUESHIELD
OH
Enumeration date
01/24/2006
Last updated
04/18/2009
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