Davis, Gwen K

Davis, Gwen K is an individual health care provider with primary practice located at 1000 Johnson Ferry Rd Ne , Atlanta GA 30342-1606. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as her primary health care specialty. Davis, Gwen K can be contacted via phone (770) 645-9181.

Contact Information

Primary practice address
1000 Johnson Ferry Rd Ne Atlanta GA 30342-1606
Phone: (770) 645-9181
Fax: (770) 645-8455
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 30042 Georgia

Profile Details

NPI number 1457347478
LBN Legal business name Davis, Gwen K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2005
Last updated Aug 26th, 2013 - about 12 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 1457347478 NPPES
Georgia MEDICAID 000429415D
Georgia MEDICAID 000429415C
Georgia MEDICAID 000429415B

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