Individual
IRA D DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-7700
(440) 449-1555
Mailing address
3605 WARRENSVILLE CENTER RD, SHAKER HTS, OH 44122-5203
(440) 684-5829
(440) 449-1555
Taxonomy
Speciality
Code
Description
License number
State
2080P0210X
Pediatric Nephrology Physician
Primary
35-054701
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000028300
ANTHEM
OH
05
—
0795591
—
OH
01
—
37000191
RAILROAD MEDICARE
OH
Enumeration date
09/27/2006
Last updated
07/08/2007
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