Provider Demographics
NPI:1356584031
Name:DAVIS, MUHAMMAD B I (LPN)
Entity type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:B
Last Name:DAVIS
Suffix:I
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8022 DECKER AVE APT UP
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44103-2995
Mailing Address - Country:US
Mailing Address - Phone:216-224-8360
Mailing Address - Fax:
Practice Address - Street 1:8022 DECKER AVE APT UP
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44103-2995
Practice Address - Country:US
Practice Address - Phone:216-224-8360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-10
Last Update Date:2009-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN. 130381 IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse