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
1	207Q00000X	Family Medicine Physician	20A5673	CA
2	208M00000X	Hospitalist Physician	20A5673	CA

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	:	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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Directions to “ DR. MICHAEL EDWARD DAVIS DO” Practice Location

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