MEDICARE: CARMEN DAVIS HIS

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	237700000X	Hearing Instrument Specialist	1684	NC

General Provider Information

NPI Number	:	1215756176
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARMEN DAVIS HIS

Provider Business Mailing Address
First Line	:	123 W CENTER STREET EXT
Second Line	:
City	:	LEXINGTON
State	:	NC
Zip	:	27295-1548
Country	:	US
Telephone Number	:	336-243-6150
Fax Number	:	336-734-2676

Provider Business Practice Location Address
First Line	:	123 W CENTER STREET EXT
Second Line	:
City	:	LEXINGTON
State	:	NC
Zip	:	27295-1548
Country	:	US
Telephone Number	:	336-243-6150
Fax Number	:	336-734-2676

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

Provider Enumeration Date	:	10/08/2024
Last Update Date	:	10/08/2024

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