Individual
KATHRYN M DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
926 S WASHINGTON AVE, HOLLAND, MI 49423-7725
(616) 393-0166
Mailing address
926 WASHINGTON AVE BLDG C, HOLLAND, MI 49423-7725
(616) 393-0166
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
4301076406
MI
208000000X
Pediatrics Physician
Primary
4301076406
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4301076406
PHYSICIAN LICENSE
MI
05
—
4605877 TYPE 10
—
MI
01
—
5315015179
BOARD OF PHARMACY
MI
Enumeration date
02/24/2006
Last updated
03/07/2023
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