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Individual

MICHAEL P DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
269 PORTLAND WAY S, GALION, OH 44833-2312
(419) 462-4600
(419) 462-4609
Mailing address
3433 AGLER RD, SUITE 2400, COLUMBUS, OH 43219-3387
(614) 428-5553
(614) 428-5515

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35085013
OH
207RC0000X
Cardiovascular Disease Physician
Primary
35085013
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2535868
OH
05
3810015439
WV
01
H378641
MEDICARE
OH
Enumeration date
11/17/2005
Last updated
11/18/2020
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