MEDICARE: DAVONTI BELL

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	343900000X	Non-emergency Medical Transport (VAN)	B4001619209000	WI

General Provider Information

NPI Number	:	1477205797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVONTI BELL

Provider Business Mailing Address
First Line	:	1302 W COTTAGE PL
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53206-2735
Country	:	US
Telephone Number	:	414-937-1238
Fax Number	:

Provider Business Practice Location Address
First Line	:	1302 W COTTAGE PL
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53206-2735
Country	:	US
Telephone Number	:	414-937-1238
Fax Number	:

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

Provider Enumeration Date	:	01/19/2022
Last Update Date	:	01/19/2022

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Directions to “ DAVONTI BELL ” Practice Location

Language	Start Address	Practice Location

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