Jerome M. Davis MD
Anesthesiology Physician in Columbia, SC(View on Map)
Full Name
Jerome M. Davis MD
NPI Number
1053370361
NPI Type
Individual Provider
Gender
Male
Enumeration Date
03/23/2006
Specialties
(Taxonomies)Code
207L00000X
207LP2900X
Primary Taxonomy
Yes
No
Licenses
State
South Carolina
License Number
11391
Contact
Information
Purpose
Mailing
Location
Address
1655 BERNARDIN AVE
1655 BERNARDIN AVE
City
Columbia
Columbia
State
SC
SC
Postal Code
29204-2039
29204-2039
Country
US
US
Telephone Number
(803) 865-4780
(803) 865-4780
Identifiers
Identifier
C606001358
113914
Identifier State
SC
SC
Identifier Issuer
MEDICARE PTAN
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 06/20/2014