Provider Demographics
NPI:1558384180
Name:DAVIES, ROBERT C (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:C
Last Name:DAVIES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1301 SIGMAN RD NE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-3812
Mailing Address - Country:US
Mailing Address - Phone:678-609-4927
Mailing Address - Fax:678-609-4928
Practice Address - Street 1:1301 SIGMAN RD NE
Practice Address - Street 2:SUITE 130
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-3812
Practice Address - Country:US
Practice Address - Phone:678-609-4927
Practice Address - Fax:678-806-5004
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2012-05-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ME016775208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
D06890Medicare UPIN