Provider Demographics
NPI:1245867100
Name:DAVIS, ANDREW JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:JOSEPH
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3280 HOWELL MILL RD NW STE 150
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-4102
Mailing Address - Country:US
Mailing Address - Phone:404-351-7467
Mailing Address - Fax:470-885-5144
Practice Address - Street 1:3280 HOWELL MILL RD NW STE 150
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-4102
Practice Address - Country:US
Practice Address - Phone:404-351-7467
Practice Address - Fax:470-885-5144
Is Sole Proprietor?:No
Enumeration Date:2020-03-23
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA95994207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty