MEDICARE: DR. JULIE MEREDITH DAVIS LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	6301014418	MI

General Provider Information

NPI Number	:	1265776629
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JULIE MEREDITH DAVIS LP

Provider Business Mailing Address
First Line	:	5708 VENTURE CT STE B
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49009-2858
Country	:	US
Telephone Number	:	269-459-1818
Fax Number	:	269-365-9951

Provider Business Practice Location Address
First Line	:	5708 VENTURE CT STE B
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49009-2858
Country	:	US
Telephone Number	:	269-459-1818
Fax Number	:	269-365-9951

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/23/2012
Last Update Date	:	04/23/2026

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