Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0401X | Family Doctor - Addiction Medicine | 9800231 | NC |
Y | 207V00000X | Obstetrician & Gynecologist | 9800231 | NC |
NPI | 1528008265 |
---|---|
Provider Name | Alan Shay Davis |
First Address | Fayetteville, NC 28304-3688 |
Second Address | Fayetteville, NC 28304-1608 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 01/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8911377 | (05) | NC |