MEDICARE: EBONY DANIELLE DAVIS

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	171W00000X	Contractor		IN

General Provider Information

NPI Number	:	1356078729
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EBONY DANIELLE DAVIS

Provider Business Mailing Address
First Line	:	5437 FALLWOOD DR APT 115
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-5657
Country	:	US
Telephone Number	:	790-431-7480
Fax Number	:

Provider Business Practice Location Address
First Line	:	5437 FALLWOOD DR APT 115
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-5657
Country	:	US
Telephone Number	:	790-431-7480
Fax Number	:

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

Provider Enumeration Date	:	08/04/2022
Last Update Date	:	08/04/2022

Similar Medicare Providers

1649088311 — FRUITOFTHESPIRITLLC
Practice Location Address:

5437 FALLWOOD DR APT 115
INDIANAPOLIS, IN
46220-5657

Practice Phone: 317-444-9057
Practice Fax:

1316942394 — INDIANAPOLIS PHYSICAL THERAPY AND SPORTS MEDICINE INC
Practice Location Address:

3830 SHORE DR
INDIANAPOLIS, IN
46254-5657

Practice Phone: 317-298-9746
Practice Fax: 317-356-4586

1841299724 — INDIANAPOLIS REGIONAL PET SCAN LLC
Practice Location Address:

3830 SHORE DR , SUITE B
INDIANAPOLIS, IN
46254-5657

Practice Phone: 317-297-0000
Practice Fax:

1255395356 — MEGAN O'CONNOR P.T.
Practice Location Address:

3830 SHORE DR , SUITE A
INDIANAPOLIS, IN
46254-5657

Practice Phone: 317-298-9746
Practice Fax:

1467660514 — MR. WILLIAM MARTIN BECK II PT
Practice Location Address:

3830 SHORE DR , SUITE A
INDIANAPOLIS, IN
46254-5657

Practice Phone: 317-298-9746
Practice Fax: 317-290-0847

1326275371 — MATTHEW T FREIJE DPT
Practice Location Address:

3830 SHORE DR , STE A
INDIANAPOLIS, IN
46254-5657

Practice Phone: 317-298-9746
Practice Fax: 317-290-0847

Directions to “ EBONY DANIELLE DAVIS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.