| Organization Name: | MICHAEL S DAVIDOV, MD, INC, PS |
| NPI Number: | 1174831192 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL S DAVIDOV (PRESIDENT) |
| Mailing Address: | 34509 9th Avenue South #207 Federal Way |
| State: | WA US |
| Postal Code: | 980038709 |
| Phone Number: | 2538159595 |
| Fax Number: | 2538159797 |
| NPI Enumeration Date: | 09/24/2010 |
| NPI Last Update Date: | 12/16/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | MD00034406 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |