Healthcare Provider Details

I. General information

NPI: 1386164820
Provider Name (Legal Business Name): DAVIS & DAVIS MANAGEMENT GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2017
Last Update Date: 04/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 S MAIN ST
LAPEER MI
48446-2426
US

IV. Provider business mailing address

1920 LIVERNOIS RD STE B
TROY MI
48083-1770
US

V. Phone/Fax

Practice location:
  • Phone: 586-431-0222
  • Fax:
Mailing address:
  • Phone: 586-431-0222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateMI

VIII. Authorized Official

Name: DR. MICHAEL DAVIS
Title or Position: MEMBER
Credential: MD
Phone: 586-431-0222