MEDICARE: TREVOR A DAVY DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	36003396	OH

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

General Provider Information

NPI Number	:	1306830294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TREVOR A DAVY DPM

Provider Business Mailing Address
First Line	:	6024 HOOVER RD
Second Line	:	SUITE F
City	:	GROVE CITY
State	:	OH
Zip	:	43123-8133
Country	:	US
Telephone Number	:	614-539-4964
Fax Number	:	614-539-4609

Provider Business Practice Location Address
First Line	:	6024 HOOVER RD
Second Line	:	SUITE F
City	:	GROVE CITY
State	:	OH
Zip	:	43123-8133
Country	:	US
Telephone Number	:	617-539-4934
Fax Number	:	614-539-4609

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

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	03/13/2012

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