Provider Demographics
NPI:1265881973
Name:DAVIS, ALLIE M (DO)
Entity type:Individual
Prefix:DR
First Name:ALLIE
Middle Name:M
Last Name:DAVIS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:3770 WIGMAN RD APT 1
Mailing Address - Street 2:
Mailing Address - City:HOLT
Mailing Address - State:MI
Mailing Address - Zip Code:48842-7749
Mailing Address - Country:US
Mailing Address - Phone:406-270-4963
Mailing Address - Fax:
Practice Address - Street 1:965 FEE RD RM A233
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48824-6410
Practice Address - Country:US
Practice Address - Phone:517-353-4362
Practice Address - Fax:517-432-0927
Is Sole Proprietor?:No
Enumeration Date:2016-06-03
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI51010224172084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry