Doctor Name: | SEAN DAVIES |
NPI Number: | 1083964274 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | APRN |
License Number: | 2012032343 |
Business Practice Address: | 7979 Big Bend Blvd Webster Groves, MO - 631192703 |
Business Phone Number: | 3149616631 |
Business Fax Number: | |
Mailing Address: | 7979 Big Bend Blvd, WEBSTER GROVES |
State: | MO |
Postal Code: | 631192703 |
Phone Number: | 3149616631 |
Fax Number: | |
NPI Enumeration Date: | 09/14/2012 |
NPI Last Update Date: | 09/14/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 2012032343 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |