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General NPI Number Information
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NPI Number | 1710965280
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Entity Type | Individual
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Provider Name | GERALD ALLEN DAVIDSON BA, BSN, MSHS, CRNA
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Gender | Male
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Dates
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Enumeration Date | 01/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 606 BLACK RIVER RD GEORGETOWN MEMORIAL HOSP ANESTHESI
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City | GEORGETOWN
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State | SC
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Zip | 29440-3304
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Country | US
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Telephone | 843-527-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 713 WINDCHIME ALY
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City | MOUNT PLEASANT
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State | SC
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Zip | 29464-7829
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Country | US
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Telephone | 843-437-4951
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Fax | 843-216-0477
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | APN 1312
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License Number State | SC
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