Individual
DANIEL E. DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1500 EAST MEDICAL CENTER DRIVE, 8TH FLOOR MEDICAL SUBSPECIALTY CLINIC, ANN ARBOR, MI 48109-4254
(734) 763-4109
Mailing address
3621 SOUTH STATE STREET, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704244629
MI
363LN0000X
Neonatal Nurse Practitioner
28192225
IN
363LN0000X
Neonatal Nurse Practitioner
71003429A
IN
Other
Enumeration date
10/29/2010
Last updated
10/04/2012
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