Individual
LESLY S DAVIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
901 VON KOLNITZ RD, SUITE 100, MT PLEASANT, SC 29464-3772
(843) 216-3376
(843) 216-3242
Mailing address
901 VON KOLNITZ RD, SUITE 100, MT PLEASANT, SC 29464-3772
(843) 216-3376
(843) 216-3242
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
17272
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
172725
—
SC
Enumeration date
06/09/2006
Last updated
08/29/2011
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