Provider Demographics
NPI:1447359336
Name:DAVIS, DAVE MCALLISTER (MD)
Entity type:Individual
Prefix:
First Name:DAVE
Middle Name:MCALLISTER
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 COLLIER RD NW
Mailing Address - Street 2:M-215
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1613
Mailing Address - Country:US
Mailing Address - Phone:404-355-2914
Mailing Address - Fax:404-355-2917
Practice Address - Street 1:35 COLLIER RD NW
Practice Address - Street 2:M-215
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1613
Practice Address - Country:US
Practice Address - Phone:404-355-2914
Practice Address - Fax:404-355-2917
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA12156174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA12156OtherMEDICAL LICENSE
GAAD1138836OtherDEA
GAAD1138836OtherDEA