MEDICARE: YVONNE J DAVIS 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	207R00000X	Internal Medicine Physician	29692	SC

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	:	1639107162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YVONNE J DAVIS MD

Provider Business Mailing Address
First Line	:	213 CHIPPING SPARROW DR
Second Line	:
City	:	SUMMERVILLE
State	:	SC
Zip	:	29485-4216
Country	:	US
Telephone Number	:	305-815-7079
Fax Number	:

Provider Business Practice Location Address
First Line	:	1156 BOWMAN RD
Second Line	:	SUITE 250
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29464-3803
Country	:	US
Telephone Number	:	843-856-3784
Fax Number	:

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

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	05/11/2015

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