MEDICARE: MELANIE R DAVIDSON MD

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	207RC0000X	Cardiovascular Disease Physician	MD37717	TN
2	207RC0000X	Cardiovascular Disease Physician	0101237859	VA

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	:	1487610507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE R DAVIDSON MD

Provider Business Mailing Address
First Line	:	1021 COOLIDGE ST
Second Line	:	SUITE 5
City	:	GREENEVILLE
State	:	TN
Zip	:	37743-4672
Country	:	US
Telephone Number	:	423-278-1842
Fax Number	:	423-278-1844

Provider Business Practice Location Address
First Line	:	1021 COOLIDGE ST
Second Line	:	SUITE 5
City	:	GREENEVILLE
State	:	TN
Zip	:	37743-4672
Country	:	US
Telephone Number	:	423-278-1842
Fax Number	:	423-278-1844

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

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	04/24/2017

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