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General NPI Number Information
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NPI Number | 1982631768
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Entity Type | Individual
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Provider Name | SAMUEL P DAVIS III MD
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Gender | Male
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 05/07/2021
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Provider Practice Location Address
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Address Line | 2707 MEDICAL OFFICE PL
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City | GOLDSBORO
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State | NC
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Zip | 27534-9458
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Country | US
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Telephone | 919-735-9146
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Fax | 919-735-0582
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Provider Business Mailing Address
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Address Line | 2000 PERIMETER PARK DR STE 200
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City | MORRISVILLE
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State | NC
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Zip | 27560-8442
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 01070226A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207YS0123X
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Taxonomy Name | Facial Plastic Surgery Physician
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License Number | 01070226A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 9900469
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License Number State | NC
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