MEDICARE: JAMES A DAVIS M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	38925	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1060Y	OTHER	NC	BCBSNC
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134179542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES A DAVIS M.D

Provider Business Mailing Address
First Line	:	1900 RANDOLPH RD
Second Line	:	STE 900
City	:	CHARLOTTE
State	:	NC
Zip	:	28207-1106
Country	:	US
Telephone Number	:	704-377-2424
Fax Number	:	704-377-2687

Provider Business Practice Location Address
First Line	:	1900 RANDOLPH RD
Second Line	:	STE 900
City	:	CHARLOTTE
State	:	NC
Zip	:	28207-1106
Country	:	US
Telephone Number	:	704-377-2424
Fax Number	:	704-377-2687

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	10/30/2007

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Directions to “ JAMES A DAVIS M.D” Practice Location

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