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NPI Code Detail

MEDICARE: MARIO DAVISON

MEDICARE: MARIO DAVISON
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1780161828
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIO DAVISON
Provider Business Mailing Address
First Line : 2177 MOCK RD
Second Line :
City : COLUMBUS
State : OH
Zip : 43219-1258
Country : US
Telephone Number : 614-914-8781
Fax Number : 614-914-8941
Provider Business Practice Location Address
First Line : 2177 MOCK RD
Second Line :
City : COLUMBUS
State : OH
Zip : 43219-1258
Country : US
Telephone Number : 614-914-8781
Fax Number : 614-914-8941
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2018
Last Update Date : 11/30/2023

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Directions to “ MARIO DAVISON ” Practice Location

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