Provider Demographics
NPI:1184409955
Name:DAVISON MEDICAL PRACTICE PLC
Entity type:Organization
Organization Name:DAVISON MEDICAL PRACTICE PLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SALWA
Authorized Official - Middle Name:SIRELKHATIM
Authorized Official - Last Name:MOHAMEDAHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-653-0899
Mailing Address - Street 1:8273 S SAGINAW ST STE B
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-2465
Mailing Address - Country:US
Mailing Address - Phone:810-653-0899
Mailing Address - Fax:810-771-7472
Practice Address - Street 1:8273 S SAGINAW ST STE B
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-2465
Practice Address - Country:US
Practice Address - Phone:810-653-0899
Practice Address - Fax:810-771-7472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-29
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty