Individual
JOHN WALLACE DAVIES II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 N FANT ST, ANDERSON, SC 29621-5708
(864) 512-1970
Mailing address
800 N FANT ST, ANDERSON, SC 29621-5708
(864) 512-1970
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
19493
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89066GY
—
NC
05
—
T35879
—
SC
Enumeration date
04/07/2006
Last updated
10/18/2007
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