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General NPI Number Information
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NPI Number | 1083758536
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Entity Type | Individual
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Provider Name | CHARLES WILLIAM DAVIS II M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/17/2007
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Last Update Date | 02/20/2024
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Provider Practice Location Address
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Address Line | 2629 WINDGUARD CIR
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-7355
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Country | US
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Telephone | 813-994-2225
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Fax |
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Provider Business Mailing Address
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Address Line | 31242 AMBERLEA RD
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City | DADE CITY
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State | FL
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Zip | 33523-7221
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | D0066013
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | ME129293
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License Number State | FL
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