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Individual

MICHAEL DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
251 E ANTIETAM ST, HAGERSTOWN, MD 21740-5724
(240) 313-9500
Mailing address
PO BOX 631479, BALTIMORE, MD 21263-1479
(301) 293-0232

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
C0002285
MD
363AM0700X
Medical Physician Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
45160100
MD
Enumeration date
06/19/2006
Last updated
03/22/2019
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