Individual
DR. ROBERT CULLEN DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2900 BRADFORD ST NE, GRAND RAPIDS, MI 49525-6427
(616) 885-5000
(616) 885-5020
Mailing address
PO BOX 1687, GRAND RAPIDS, MI 49501-1687
(616) 486-9280
(616) 974-9064
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
4301034558
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060053856
RAILROAD MEDICARE
MI
05
—
4709460
—
MI
Enumeration date
11/28/2005
Last updated
03/19/2013
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