Individual
EDWIN B. DAVIS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
502 VAN BUREN ST, FOSTORIA, OH 44830-1533
(419) 436-6697
(419) 436-6612
Mailing address
502 VAN BUREN ST, FOSTORIA, OH 44830-1533
(419) 436-6697
(419) 436-6612
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35029216
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000375015
ANTHEM
OH
05
—
0136392
—
OH
01
—
04788
PARAMOUNT
OH
01
—
24-54053
UHC
OH
01
—
PENDING
AETNA
OH
Enumeration date
05/04/2006
Last updated
07/08/2007
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