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NPI Code Detail

MEDICARE: JOHN SAMUEL DAVIS MD

MEDICARE: JOHN SAMUEL 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
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician200100347NC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2220031677OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3130X2OTHERNCBCBS OF NC

General Provider Information

NPI Number : 1811948292
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN SAMUEL DAVIS MD
Provider Business Mailing Address
First Line : PO BOX 409
Second Line :
City : BLUEFIELD
State : WV
Zip : 24701-0409
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 68 HOSPITAL RD
Second Line :
City : SYLVA
State : NC
Zip : 28779-2722
Country : US
Telephone Number : 828-586-7114
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2006
Last Update Date : 06/12/2013

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