Provider Demographics
NPI:1154709459
Name:DAVIS, DEBORAH (PA-C)
Entity type:Individual
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First Name:DEBORAH
Middle Name:
Last Name:DAVIS
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:MEDICAL CENTER BLVD
Mailing Address - Street 2:WAKE FOREST SCHOOL OF MEDICINE, DEPT OF CT SURGERY
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27157-1096
Mailing Address - Country:US
Mailing Address - Phone:336-716-2124
Mailing Address - Fax:336-716-3348
Practice Address - Street 1:MEDICAL CENTER BLVD
Practice Address - Street 2:WAKE FOREST SCHOOL OF MEDICINE, DEPT OF CT SURGERY
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27157-1096
Practice Address - Country:US
Practice Address - Phone:336-716-2124
Practice Address - Fax:336-716-3348
Is Sole Proprietor?:No
Enumeration Date:2015-05-07
Last Update Date:2015-05-07
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical