Individual
DANIELLE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3635 VISTA AVE AT GRAND BLVD, SAINT LOUIS, MO 63110
(314) 268-7133
Mailing address
3635 VISTA AVE AT GRAND BLVD, SAINT LOUIS, MO 63110
(314) 268-7133
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036144723
IL
207P00000X
Emergency Medicine Physician
Primary
A156356
CA
Other
Enumeration date
06/24/2015
Last updated
08/14/2018
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