Provider Demographics
NPI:1912970559
Name:DAVIS, ROBERT MARC (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:MARC
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 HUFF AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-5382
Mailing Address - Country:US
Mailing Address - Phone:412-295-6950
Mailing Address - Fax:
Practice Address - Street 1:211 HUFF AVE
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-5382
Practice Address - Country:US
Practice Address - Phone:412-295-6950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4183042084P0800X
NJ25MA078181002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ096827BSUOtherMEDICARE LEGACY NJ
PAH83062Medicare UPIN
NJ096827BSUOtherMEDICARE LEGACY NJ