Provider Demographics
NPI:1992749188
Name:DAVIES, ELIZABETH EMILIE (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:EMILIE
Last Name:DAVIES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:EMILIE
Other - Last Name:BERGMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:21 THE GREEN
Mailing Address - Street 2:
Mailing Address - City:CHARLBURY
Mailing Address - State:OXFORDSHIRE
Mailing Address - Zip Code:OX7 3QA
Mailing Address - Country:GB
Mailing Address - Phone:01144160-881-0811
Mailing Address - Fax:
Practice Address - Street 1:UNIT 5210
Practice Address - Street 2:BOX 230
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09461
Practice Address - Country:GB
Practice Address - Phone:01144163-852-8124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI46949-020207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34555700Medicaid
WI34555700Medicaid