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NPI Code Detail

MEDICARE: DR. MARK F DAVIS MD

MEDICARE: DR. MARK F 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
1207R00000XInternal Medicine Physician29044WI

General Provider Information

NPI Number : 1366414161
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK F DAVIS MD
Provider Business Mailing Address
First Line : 202 S PARK ST
Second Line :
City : MADISON
State : WI
Zip : 53715-1507
Country : US
Telephone Number : 608-417-6000
Fax Number :
Provider Business Practice Location Address
First Line : 7780 ELMWOOD AVE
Second Line :
City : MIDDLETON
State : WI
Zip : 53562-5407
Country : US
Telephone Number : 608-417-3434
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2006
Last Update Date : 03/29/2012

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