Davis, Matthew Edwin

Davis, Matthew Edwin is an sole proprietor health care provider with primary practice located at 33 Upper Riverdale Rd Sw Suite 117, Riverdale GA 30274-2626. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Davis, Matthew Edwin can be contacted via phone (770) 991-1170.

Contact Information

Primary practice address
33 Upper Riverdale Rd Sw Suite 117 Riverdale GA 30274-2626
Phone: (770) 991-1170
Fax: (770) 991-0107
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 016052 Georgia

Profile Details

NPI number 1225105489
LBN Legal business name Davis, Matthew Edwin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 30th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225105489 NPPES
Georgia MEDICAID 00065403B

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