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NPI Code Detail

MEDICARE: SAMANTHA DAVIS

MEDICARE: SAMANTHA DAVIS
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
1247200000XOther Technician

General Provider Information

NPI Number : 1558886630
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA DAVIS
Provider Business Mailing Address
First Line : 3769 QUARTON RD
Second Line :
City : BLOOMFIELD HILLS
State : MI
Zip : 48302-4058
Country : US
Telephone Number : 248-894-1966
Fax Number :
Provider Business Practice Location Address
First Line : 3769 QUARTON RD
Second Line :
City : BLOOMFIELD HILLS
State : MI
Zip : 48302-4058
Country : US
Telephone Number : 248-894-1966
Fax Number : 303-264-3879
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2017
Last Update Date : 06/09/2025

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Directions to “ SAMANTHA DAVIS ” Practice Location

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