Healthcare Provider Details

I. General information

NPI: 1134075013
Provider Name (Legal Business Name): ALEXIA DAVIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2026
Last Update Date: 03/04/2026
Certification Date: 03/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 AUGUSTA RD
WEST COLUMBIA SC
29169-4543
US

IV. Provider business mailing address

1127 OLD BARNWELL RD
WEST COLUMBIA SC
29170-3413
US

V. Phone/Fax

Practice location:
  • Phone: 803-791-8114
  • Fax:
Mailing address:
  • Phone: 803-556-1529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number49530
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: