Provider Demographics
NPI:1962480160
Name:DAVEY, CHRISTOPHER M (MD, PA)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:M
Last Name:DAVEY
Suffix:
Gender:M
Credentials:MD, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2191 9TH AVE N
Mailing Address - Street 2:SUITE 115
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-7146
Mailing Address - Country:US
Mailing Address - Phone:727-321-1234
Mailing Address - Fax:727-827-2966
Practice Address - Street 1:2191 9TH AVE N
Practice Address - Street 2:SUITE 115
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-7146
Practice Address - Country:US
Practice Address - Phone:727-321-1234
Practice Address - Fax:727-827-2966
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-06
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME34037207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD85391Medicare UPIN
FL23021Medicare ID - Type Unspecified
FLD85391Medicare UPIN