Provider Demographics
NPI:1265602619
Name:DAVIS, DAWN RENEE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:DAWN
Middle Name:RENEE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:RENEE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1501 ASHBURTON RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-2510
Mailing Address - Country:US
Mailing Address - Phone:919-233-8758
Mailing Address - Fax:
Practice Address - Street 1:1501 ASHBURTON RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-2510
Practice Address - Country:US
Practice Address - Phone:919-233-8758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-01
Last Update Date:2008-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC104611835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric