Individual
MAXWELL DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2455 N 124TH ST, BROOKFIELD, WI 53005-4630
(414) 477-1504
Mailing address
2455 N 124TH ST, BROOKFIELD, WI 53005-4630
(414) 477-1504
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036-113273
IL
207P00000X
Emergency Medicine Physician
Primary
48659-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000
BCBS
WI
05
—
34968400
—
WI
Enumeration date
07/20/2006
Last updated
01/05/2026
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