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General NPI Number Information
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NPI Number | 1982636726
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Entity Type | Organization
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Legal Business Name | WILLIAM R DAVIS MD SC
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 10/23/2007
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Provider Practice Location Address
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Address Line | 2600 N MAYFAIR RD SUITE 950
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City | WAUWATOSA
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State | WI
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Zip | 53226-1309
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Country | US
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Telephone | 414-456-1123
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Fax | 414-456-1766
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Provider Business Mailing Address
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Address Line | 2600 N MAYFAIR RD SUITE 950
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City | WAUWATOSA
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State | WI
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Zip | 53226-1309
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Country | US
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Telephone | 414-456-1123
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Fax | 414-456-1766
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Authorized Official
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Title or Position | OWNER
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Name | WILLIAM R DAVIS
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Credential | MD
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Telephone | 414-456-1123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 36170
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License Number State | WI
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