Provider Demographics
NPI:1639425754
Name:DAVIS, BRYAN F (DO)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:F
Last Name:DAVIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1A REGULUS DR
Mailing Address - Street 2:
Mailing Address - City:TURNERSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-2427
Mailing Address - Country:US
Mailing Address - Phone:844-542-2273
Mailing Address - Fax:856-256-7518
Practice Address - Street 1:100 KINGS WAY E STE B1
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-2237
Practice Address - Country:US
Practice Address - Phone:856-536-1515
Practice Address - Fax:856-412-5324
Is Sole Proprietor?:No
Enumeration Date:2012-07-26
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000004846207RE0101X
NY325394207RE0101X
NJ25MB09665900207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism