MEDICARE: DR. GEORGE EDWARD DAVIS MD

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	208000000X	Pediatrics Physician	20383	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	02448	OTHER		BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346220241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE EDWARD DAVIS MD

Provider Business Mailing Address
First Line	:	1206 BROWN ST
Second Line	:
City	:	WASHINGTON
State	:	NC
Zip	:	27889-4671
Country	:	US
Telephone Number	:	252-946-4134
Fax Number	:	252-946-2432

Provider Business Practice Location Address
First Line	:	1206 BROWN ST
Second Line	:
City	:	WASHINGTON
State	:	NC
Zip	:	27889-4671
Country	:	US
Telephone Number	:	252-946-4134
Fax Number	:	252-946-2432

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

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	01/16/2012

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