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NPI Code Detail

MEDICARE: MARJORIE MCELREATH DAVISON

MEDICARE:   MARJORIE MCELREATH DAVISON
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
1363LF0000XFamily Nurse Practitioner231815GA
2363L00000XNurse Practitioner231815GA

General Provider Information

NPI Number : 1285152132
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARJORIE MCELREATH DAVISON
Provider Business Mailing Address
First Line : 2665 N DECATUR RD STE 520
Second Line :
City : DECATUR
State : GA
Zip : 30033-6146
Country : US
Telephone Number : 404-299-2223
Fax Number :
Provider Business Practice Location Address
First Line : 2665 N DECATUR RD STE 520
Second Line :
City : DECATUR
State : GA
Zip : 30033-6146
Country : US
Telephone Number : 404-299-2223
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2017
Last Update Date : 01/03/2019

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Directions to “ MARJORIE MCELREATH DAVISON ” Practice Location

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