Individual
SAMUEL R DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 6TH AVE, MONTGOMERY, WV 25136-2117
(304) 442-5151
(304) 442-1347
Mailing address
400 6TH AVE, MONTGOMERY, WV 25136-2117
(304) 442-5151
(304) 442-1347
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
13914
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0117385000
—
WV
Enumeration date
04/26/2006
Last updated
07/08/2007
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