Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 563 | NC |
Y | 222Z00000X | Podiatrist | 563 | NC |
N | 213EP1101X | Primary Podiatric Medicine | 563 | NC |
N | 213ES0103X | Foot & Ankle Surgery | 563 | NC |
N | 213ES0131X | Foot Surgery | 563 | NC |
NPI | 1356599096 |
---|---|
Provider Name | Dr. Matthew Warren Davis |
First Address | Waynesville, NC 28785-9006 |
Second Address | Waynesville, NC 28785-9006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2008 |
Last Update Date | 09/07/2013 |