Provider Demographics
NPI:1831217272
Name:DAVIS, ROBERT M (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:M
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5080 SPECTRUM DR
Mailing Address - Street 2:SUITE 1200 WEST
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-4648
Mailing Address - Country:US
Mailing Address - Phone:972-364-8000
Mailing Address - Fax:214-775-4515
Practice Address - Street 1:5850 S POLARIS RD
Practice Address - Street 2:SUITE 100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-3185
Practice Address - Country:US
Practice Address - Phone:702-739-9957
Practice Address - Fax:702-739-9370
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2011-11-17
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Provider Licenses
StateLicense IDTaxonomies
NV113762083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVBK083AMedicare PIN
NVBP492YMedicare UPIN
NVBK083BMedicare PIN
NVBP492ZMedicare UPIN