Brad Jacob Davis
Pathology, Anatomic Pathology & Clinical Pathology in Duluth, MN. Individual provider (NPI-1).
NPI number1992736268
StatusActive
Last updated in NPPESMay 19, 2011
Details
- NPI
- 1992736268
- Entity type
- Individual (NPI-1)
- Name
- Brad Jacob Davis
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 5, 2006
- Last updated
- May 19, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207ZP0102X | Pathology, Anatomic Pathology & Clinical Pathology | 44532 | MN | Yes |
| 207ZH0000X | Pathology, Hematology | 44532 | MN |
Practice location
400 E 3rd StDuluth, MN 55805-1951
Phone 218-786-8364
Mailing address
400 E 3rd StDuluth, MN 55805-1951
Phone 218-786-8364
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