Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 83990 | SC |
NPI | 1003255548 |
---|---|
Provider Name | Nathan Chadwick Davis |
First Address | West Columbia, SC 29171-6069 |
Second Address | West Columbia, SC 29169-4847 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2013 |
Last Update Date | 27/10/2020 |