Provider Demographics
NPI:1093446361
Name:DAVIS, CHRISTOPHER TYRON
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:TYRON
Last Name:DAVIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 C ST SE APT 413
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-2674
Mailing Address - Country:US
Mailing Address - Phone:202-321-8530
Mailing Address - Fax:
Practice Address - Street 1:1739 7TH ST NW APT 1
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-3143
Practice Address - Country:US
Practice Address - Phone:202-518-7721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-18
Last Update Date:2022-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant