Provider Demographics
NPI:1720492945
Name:DAVIS, INGA (AA)
Entity Type:Individual
Prefix:
First Name:INGA
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:AA
Other - Prefix:
Other - First Name:INGA
Other - Middle Name:
Other - Last Name:CARSTENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 20452
Mailing Address - Street 2:COA-CRED
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-0452
Mailing Address - Country:US
Mailing Address - Phone:614-442-2406
Mailing Address - Fax:614-442-2410
Practice Address - Street 1:500 S CLEVELAND AVE
Practice Address - Street 2:COA-ANESTHESIA DEPT
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-8971
Practice Address - Country:US
Practice Address - Phone:614-898-6659
Practice Address - Fax:614-898-8631
Is Sole Proprietor?:No
Enumeration Date:2014-06-16
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH67.000229367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant