Most Relevant Information
Provider Data
| NPI Number: | 1003533456 |
| Provider Name: | SHATAQUWA D DAVIS |
| Entity Type: | Individual |
| Taxonomy Code: | 174400000X |
| Specialty: | Specialist |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/26/2022 |
| Last Updated: | 10/26/2022 |
Provider Practice Location
9812 LOCKPORT RD
NIAGARA FALLS
NY
143041114
Practice Location Phone/Fax
| Phone: | 7162970798 |
| Fax: | 7162970998 |
Provider Mailing Location
9812 LOCKPORT RD
NIAGARA FALLS
NY
143041114
Provider Mailing Phone/Fax
| Phone: | 7162971478 |
| Fax: | 7162970998 |