Most Relevant Information
Provider Data
| NPI Number: | 1003457680 |
| Provider Name: | KEJUAN DESHAWN DAVIS |
| Entity Type: | Individual |
| Taxonomy Code: | 172A00000X |
| Specialty: | Driver |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/04/2019 |
| Last Updated: | 10/04/2019 |
Provider Practice Location
7401 PARKLAND
REDFORD
MI
482391015
Practice Location Phone/Fax
| Phone: | 3139142117 |
| Fax: |
Provider Mailing Location
17583 HARTWELL ST
DETROIT
MI
482352639
Provider Mailing Phone/Fax
| Phone: | 3132866790 |
| Fax: |