Provider Demographics
NPI:1376953844
Name:DAVIDSON, DONALD GREGORY (RPH)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:GREGORY
Last Name:DAVIDSON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 N LAPEER RD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48371-3619
Mailing Address - Country:US
Mailing Address - Phone:248-236-8010
Mailing Address - Fax:248-236-8065
Practice Address - Street 1:900 N LAPEER RD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MI
Practice Address - Zip Code:48371-3619
Practice Address - Country:US
Practice Address - Phone:248-236-8010
Practice Address - Fax:248-236-8065
Is Sole Proprietor?:No
Enumeration Date:2014-05-05
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302022232183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist