Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 582 | NC |
N | 213ES0131X | Foot Surgery | 582 | NC |
NPI | 1427311497 |
---|---|
Provider Name | Dr. Ashma Shalonda Davidson |
First Address | Statesville, NC 28677-3521 |
Second Address | Statesville, NC 28677-3521 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2012 |
Last Update Date | 16/02/2021 |