Provider Demographics
NPI:1366736571
Name:DAVIS, EMILY J (PA-C)
Entity type:Individual
Prefix:MISS
First Name:EMILY
Middle Name:J
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:14302 BARTON BLVD SW
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-5825
Mailing Address - Country:US
Mailing Address - Phone:301-729-3278
Mailing Address - Fax:301-729-8702
Practice Address - Street 1:14302 BARTON BLVD SW
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-5825
Practice Address - Country:US
Practice Address - Phone:301-729-3278
Practice Address - Fax:301-729-8702
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-06
Last Update Date:2013-08-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDC0004478363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant