MEDICARE: DR. CHRISTINE MARIE DAVIS M.D..

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	104296	GA
2	207R00000X	Internal Medicine Physician	01065406A	IN
3	208M00000X	Hospitalist Physician	ME173532	FL
4	207R00000X	Internal Medicine Physician	27239	AZ

General Provider Information

NPI Number	:	1780659201
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINE MARIE DAVIS M.D..

Provider Business Mailing Address
First Line	:	2525 W BERYL AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85021-1606
Country	:	US
Telephone Number	:	602-467-4757
Fax Number	:	602-371-4960

Provider Business Practice Location Address
First Line	:	3269 N STOCKTON HILL RD
Second Line	:
City	:	KINGMAN
State	:	AZ
Zip	:	86409-3619
Country	:	US
Telephone Number	:	928-757-2101
Fax Number	:

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

Provider Enumeration Date	:	02/19/2006
Last Update Date	:	07/01/2025

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