Male or Other

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

Provider Address

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