Basic Information
| Provider Information | |||||||||
| NPI: | 1316167422 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DAVIS | ||||||||
| FirstName: | CLAUDE | ||||||||
| MiddleName: | ERVIN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | III | ||||||||
| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5TH ST. | ||||||||
| Address2: | EAST CAROLINA UNIVERSITY DEPARTMENT OF PSYCHOLOGY | ||||||||
| City: | GREENVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27858 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2523286308 | ||||||||
| FaxNumber: | 2523286283 | ||||||||
| Practice Location | |||||||||
| Address1: | 600 MOYE BLVD | ||||||||
| Address2: | BRODY SCHOOL OF MEDICINE EAST CAROLINA UNIVERSITY | ||||||||
| City: | GREENVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 278344300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2527442290 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/30/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 3193 | NC | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.