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General NPI Number Information
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NPI Number | 1609959857
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Entity Type | Individual
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Provider Name | MICHAEL S DAVIDOV MD
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Gender | Male
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 05/18/2010
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Provider Practice Location Address
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Address Line | 34509 9TH AVENUE SOUTH #207
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City | FEDERAL WAY
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State | WA
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Zip | 98003
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Country | US
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Telephone | 253-815-9595
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Fax | 253-815-9797
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Provider Business Mailing Address
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Address Line | 34509 9TH AVENUE SOUTH #207
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City | FEDERAL WAY
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State | WA
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Zip | 98003
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Country | US
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Telephone | 253-815-9595
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Fax | 253-815-9797
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD00034406
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | MD00034406
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License Number State | WA
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