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Individual
VICTOR M DAVIS
Active
Individual
VICTOR M DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
6402
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012478
—
MT
01
—
870023511
RAILROAD MEDICARE
MT
01
—
95610
BLUE CROSS BLUE SHIELD
MT
Enumeration date
09/15/2006
Last updated
10/05/2007
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