MEDICARE: MECHERY DAVIS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	MD10003	RI
2	207R00000X	Internal Medicine Physician	MD10003	RI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2149156	OTHER		AETNA
2	405138	OTHER	RI	BLUECHIP
3	0402703	OTHER	RI	UNITED HEALTH CARE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	20927-8	OTHER	RI	BLUE CROSS&BLUE SHIELD

General Provider Information

NPI Number	:	1407824477
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MECHERY DAVIS MD

Provider Business Mailing Address
First Line	:	300 TOLL GATE RD
Second Line	:	SUITE # LL6
City	:	WARWICK
State	:	RI
Zip	:	02886-4416
Country	:	US
Telephone Number	:	401-732-8700
Fax Number	:	401-732-0079

Provider Business Practice Location Address
First Line	:	300 TOLL GATE RD
Second Line	:	SUITE # LL6
City	:	WARWICK
State	:	RI
Zip	:	02886-4416
Country	:	US
Telephone Number	:	401-732-8700
Fax Number	:	401-732-0079

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	10/03/2007

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Directions to “ MECHERY DAVIS MD” Practice Location

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