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General NPI Number Information
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NPI Number | 1205997640
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Entity Type | Individual
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Provider Name | CHERYL L DAVIDSON O.D.
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Gender | Female
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 09/27/2023
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Provider Practice Location Address
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Address Line | 1000 DES PERES RD STE 105
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City | SAINT LOUIS
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State | MO
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Zip | 63131-2062
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Country | US
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Telephone | 314-628-9100
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Fax | 844-235-0998
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Provider Business Mailing Address
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Address Line | 1000 DES PERES RD STE 105
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City | SAINT LOUIS
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State | MO
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Zip | 63131-2062
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Country | US
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Telephone | 314-628-9100
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Fax | 844-235-0998
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2000160780
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License Number State | MO
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