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General NPI Number Information
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NPI Number | 1619954153
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Entity Type | Individual
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Provider Name | MICHAEL EDWARD DAVIS MD
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Gender | Male
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Dates
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Enumeration Date | 12/27/2005
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Last Update Date | 04/11/2023
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Provider Practice Location Address
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Address Line | 4294 LOMAC ST
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City | MONTGOMERY
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State | AL
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Zip | 36106-3604
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Country | US
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Telephone | 334-274-9000
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Fax | 334-274-0857
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Provider Business Mailing Address
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Address Line | PO BOX 370
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City | FORTSON
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State | GA
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Zip | 31808-0370
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 24900
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License Number State | AL
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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 | 24900
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License Number State | AL
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