Davis, Brad Jacob

Davis, Brad Jacob is an individual health care provider with primary practice located at 400 E 3Rd St , Duluth MN 55805-1951. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hematology, Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology. Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology is his primary health care specialty. Davis, Brad Jacob can be contacted via phone (218) 786-8364.

Contact Information

Primary practice address
400 E 3Rd St Duluth MN 55805-1951
Phone: (218) 786-8364
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology 207ZH0000X 44532 Minnesota
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 44532 Minnesota

Profile Details

NPI number 1992736268
LBN Legal business name Davis, Brad Jacob
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2006
Last updated May 19th, 2011 - about 15 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 1992736268 NPPES
Minnesota MEDICAID 321314500

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