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General NPI Number Information
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NPI Number | 1306831300
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Entity Type | Individual
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Provider Name | ARTHUR I DAVIDA MD
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Gender | Male
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Dates
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Enumeration Date | 09/15/2005
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Last Update Date | 03/26/2012
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Provider Practice Location Address
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Address Line | 105 3RD ST
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-1212
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Country | US
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Telephone | 630-893-8050
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Fax | 630-893-8154
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Provider Business Mailing Address
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Address Line | 105 3RD ST
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-1212
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Country | US
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Telephone | 630-893-8050
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Fax | 630-893-8154
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036070839
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License Number State | IL
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