Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 2019-00705 | NC |
NPI | 1093030314 |
---|---|
Provider Name | Stephen W Davies |
First Address | Pinehurst, NC 28374-8710 |
Second Address | Pinehurst, NC 28374 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2010 |
Last Update Date | 01/10/2019 |