NPI 1003457680

Kejuan Deshawn Davis

Practitioner Driver Redford, MI

Practice location

Address: 7401 Parkland, Redford, MI 48239-1015
Phone: (313) 914-2117
Mailing address: 17583 Hartwell St, Detroit, MI 48235-2639

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X

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Registry record

NPI: 1003457680
Entity type: Individual
Sex (as registered): Male
NPI issued: 4 Oct 2019
Record last updated: 4 Oct 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.