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NPI Code Detail

MEDICARE: DR. MICHAEL EDWARD DAVIS DO

MEDICARE: DR. MICHAEL EDWARD DAVIS DO
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
1207Q00000XFamily Medicine Physician20A5673CA
2208M00000XHospitalist Physician20A5673CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548259435
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL EDWARD DAVIS DO
Provider Business Mailing Address
First Line : 23625 HOLMAN HWY
Second Line :
City : MONTEREY
State : CA
Zip : 93940-5902
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 23625 WR HOLMAN HWY
Second Line :
City : MONTEREY
State : CA
Zip : 93940-5902
Country : US
Telephone Number : 831-622-2708
Fax Number : 831-622-2709
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2005
Last Update Date : 10/21/2019

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