Davis, Michael Robert

Davis, Michael Robert is an individual health care provider with primary practice located at 7900 W Jefferson Blvd Ste 306 , Fort Wayne IN 46804-4128. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as his primary health care specialty. Davis, Michael Robert can be contacted via phone (260) 458-3610.

Contact Information

Primary practice address
7900 W Jefferson Blvd Ste 306 Fort Wayne IN 46804-4128
Phone: (260) 458-3610
Fax: (260) 458-3611
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X 26620 Alabama
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X P1857 Texas
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X 01053296A Indiana

Profile Details

NPI number 1477622934
LBN Legal business name Davis, Michael Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 7th, 2006
Last updated Apr 19th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1477622934 NPPES
Alabama MEDICAID 009941892
Alabama Other 051540216
Alabama MEDICAID 009941891
Alabama MEDICAID 009942208
Alabama Other 051540217
Alabama Other 051540215

Popular Providers