Provider Demographics
NPI:1114328408
Name:DAVIS, CHRISTOPHER ANDREW (PA-C)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ANDREW
Last Name:DAVIS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4969 CENTRE POINTE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29418-6952
Mailing Address - Country:US
Mailing Address - Phone:843-853-0250
Mailing Address - Fax:843-853-0210
Practice Address - Street 1:4969 CENTRE POINTE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29418-6952
Practice Address - Country:US
Practice Address - Phone:843-853-0250
Practice Address - Fax:843-853-0210
Is Sole Proprietor?:No
Enumeration Date:2014-09-06
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC2181363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant