MEDICARE: MARGARET RUTH DAVIS M.D.

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	207Q00000X	Family Medicine Physician	LL25138	SC
2	207Q00000X	Family Medicine Physician	25138	SC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	SC12916067	OTHER	SC	MEDICARE PIN
2	P01266652	OTHER	SC	RAILROAD MEDICARE
3	SC12916121	OTHER	SC	MEDICARE PIN
5	SC12915193	OTHER	SC	MEDICARE PIN
6	SC1291J577	OTHER	SC	MEDICARE PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477880755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARET RUTH DAVIS M.D.

Provider Business Mailing Address
First Line	:	PO BOX 743070
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-3070
Country	:	US
Telephone Number	:	864-560-4304
Fax Number	:	864-560-4413

Provider Business Practice Location Address
First Line	:	1200 E MAIN ST
Second Line	:	SUITE 12
City	:	SPARTANBURG
State	:	SC
Zip	:	29307-1711
Country	:	US
Telephone Number	:	864-560-9260
Fax Number	:	864-560-9265

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

Provider Enumeration Date	:	11/08/2009
Last Update Date	:	03/13/2020

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