Provider Demographics
NPI:1659393106
Name:DAVIS, CLAUDIA ANN (MD)
Entity type:Individual
Prefix:DR
First Name:CLAUDIA
Middle Name:ANN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NGECHE
Other - Middle Name:ANN
Other - Last Name:FOBI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3209 CRANBERRY WAY
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30094
Mailing Address - Country:US
Mailing Address - Phone:678-332-4871
Mailing Address - Fax:
Practice Address - Street 1:2745 DEKALB MEDICAL PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058
Practice Address - Country:US
Practice Address - Phone:404-446-3870
Practice Address - Fax:404-446-3875
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA82245207R00000X
MI4301076474207R00000X
GA052448207RH0002X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA676562727CMedicaid
GA676562727CMedicaid