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General NPI Number Information
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NPI Number | 1558384180
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Entity Type | Individual
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Provider Name | ROBERT C DAVIES M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 05/04/2012
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Provider Practice Location Address
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Address Line | 1301 SIGMAN RD NE SUITE 130
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City | CONYERS
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State | GA
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Zip | 30012-3812
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Country | US
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Telephone | 678-609-4927
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Fax | 678-806-5004
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Provider Business Mailing Address
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Address Line | 1301 SIGMAN RD NE SUITE 130
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City | CONYERS
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State | GA
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Zip | 30012-3812
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Country | US
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Telephone | 678-609-4927
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Fax | 678-609-4928
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 016775
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 016775
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License Number State | ME
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