Individual
DEAN ELDON DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
853 N CHURCH ST, SUITE 600, SPARTANBURG, SC 29303-3098
(864) 583-4556
(864) 560-0625
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
13797
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137970
—
SC
01
—
195789
MEDCOST
SC
01
—
4263370
AETNA
SC
05
—
790557R
—
NC
01
—
AA53843365
MEDICARE PIN
SC
Enumeration date
01/25/2006
Last updated
12/17/2020
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