Provider Demographics
NPI:1538440003
Name:DAVIS, MATTHEW STEVEN (PHARMD)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:STEVEN
Last Name:DAVIS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 NW ROCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66617-1270
Mailing Address - Country:US
Mailing Address - Phone:785-357-7397
Mailing Address - Fax:785-357-8369
Practice Address - Street 1:2600 NW ROCHESTER RD
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66617-1270
Practice Address - Country:US
Practice Address - Phone:785-357-7397
Practice Address - Fax:785-357-8369
Is Sole Proprietor?:No
Enumeration Date:2011-08-29
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-14908183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist