Individual
DR. R DALE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
704 S WEBSTER AVE, STE 102, GREEN BAY, WI 54301
(920) 433-7516
(920) 433-7464
Mailing address
704 S WEBSTER AVE, STE 102, GREEN BAY, WI 54301
(920) 433-7516
(920) 433-7464
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
30054
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31492900
—
WI
Enumeration date
08/15/2006
Last updated
07/13/2010
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