Active NPI
Michael S Davidov, MD
- Obstetrics & Gynecology Physician
- Federal Way, WA
National Provider Identifier
1609959857
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- MD00034406
- Practice address
- 34509 9TH Avenue South
#207
Federal Way, WA 98003 - Phone
- (253) 815-9595
- Fax
- (253) 815-9797
- NPI assigned
- Oct 23, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | MD00034406 | WA | Primary |
| General Practice Physician | 208D00000X | MD00034406 | WA |
Addresses
Primary practice location
34509 9TH Avenue South
#207
Federal Way, WA 98003
Mailing address
34509 9TH Avenue South
#207
Federal Way, WA 98003
Phone (253) 815-9595
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 146075 | Other | L&I | |
| 1113661 | Medicaid | WA | |
| 146075 | Other | L1 | |
| 7900749 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274140800000",
"number": "1609959857",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34509 9TH AVENUE SOUTH",
"address_2": "#207",
"city": "FEDERAL WAY",
"state": "WA",
"postal_code": "98003",
"telephone_number": "253-815-9595",
"fax_number": "253-815-9797"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34509 9TH AVENUE SOUTH",
"address_2": "#207",
"city": "FEDERAL WAY",
"state": "WA",
"postal_code": "98003",
"telephone_number": "253-815-9595",
"fax_number": "253-815-9797"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIDOV",
"first_name": "MICHAEL",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-23",
"last_updated": "2010-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "WA",
"license": "MD00034406",
"primary": true
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "WA",
"license": "MD00034406",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I",
"identifier": "146075",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1113661",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L1",
"identifier": "146075",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7900749",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Federal Way, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.