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General NPI Number Information
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NPI Number | 1639475346
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Entity Type | Individual
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Provider Name | MATTHEW WILLIAM DAVIS M.D., R.PH.
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Gender | Male
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Dates
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Enumeration Date | 01/28/2011
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Last Update Date | 09/11/2022
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Provider Practice Location Address
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Address Line | 580 5TH AVE STE 820
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City | NEW YORK
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State | NY
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Zip | 10036-4762
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Country | US
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Telephone | 267-261-5887
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Fax |
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Provider Business Mailing Address
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Address Line | 576 FIFTH AVE SUITE 903
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City | NEW YORK
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State | NY
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Zip | 10036
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Country | US
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Telephone | 267-261-5882
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Fax |
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 237105
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208U00000X
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Taxonomy Name | Clinical Pharmacology Physician
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License Number | 237105
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License Number State | NY
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