Stanley Ray Davis
Individual provider Active NPI Homemaker · Pontiac, MI
NPI 1831579523 · NPPES record last updated Jun 8, 2015
Key facts
- NPI
- 1831579523
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Homemaker 376J00000X
- Practice address
- 420 S Opdyke Rd Apt 22a
Pontiac, MI 48341-3105 - Phone
- (248) 648-5371
- NPI assigned
- Jun 8, 2015
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Homemaker | 376J00000X | Yes |
Addresses
Primary practice location
420 S Opdyke Rd Apt 22a
Pontiac, MI 48341-3105
Mailing address
420 S Opdyke Rd Apt 22a
Pontiac, MI 48341-3105
Phone (248) 648-5371
Other providers in Pontiac, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 8, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.