| Dr Michael Robert Davis, MD | |
|
7900 W Jefferson Blvd Ste 306, Fort Wayne, IN 46804-4128 | |
| (260) 458-3610 | |
| (260) 458-3611 |
| Full Name | Dr Michael Robert Davis |
|---|---|
| Gender | Male |
| Speciality | Plastic And Reconstructive Surgery |
| Experience | 27 Years |
| Location | 7900 W Jefferson Blvd Ste 306, Fort Wayne, Indiana |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477622934 | NPI | - | NPPES |
| 009941892 | Medicaid | AL | |
| 051540216 | Other | AL | BCBS |
| 009941891 | Medicaid | AL | |
| 009942208 | Medicaid | AL | |
| 051540217 | Other | AL | BCBS |
| 051540215 | Other | AL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208200000X | Plastic Surgery | 26620 (Alabama) | Secondary |
| 208200000X | Plastic Surgery | P1857 (Texas) | Secondary |
| 208200000X | Plastic Surgery | 01053296A (Indiana) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| South Texas Aesthetic And Reconstructive Surgery Pllc | 5890078703 | 4 |
| Entity Name | South Texas Aesthetic And Reconstructive Surgery Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285042556 PECOS PAC ID: 5890078703 Enrollment ID: O20170218000137 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Michael Robert Davis, MD 6920 Pointe Inverness Way Ste 200, Fort Wayne, IN 46804-7934 Ph: (260) 479-3514 | Dr Michael Robert Davis, MD 7900 W Jefferson Blvd Ste 306, Fort Wayne, IN 46804-4128 Ph: (260) 458-3610 |
Reid Robert Pflueger, DO Plastic Surgery Medicare: Accepting Medicare Assignments Practice Location: 7920 W Jefferson Blvd Ste 200, Fort Wayne, IN 46804 Phone: 260-490-7111 | |
Robert Nicholas Severinac, M.D. Plastic Surgery Medicare: Medicare Enrolled Practice Location: 10020 Dupont Circle Ct, Suite 100, Fort Wayne, IN 46825 Phone: 260-489-0099 Fax: 260-489-0066 | |
Guy G Crevecoeur, MD Plastic Surgery Medicare: Accepting Medicare Assignments Practice Location: 11141 Parkview Plaza Dr Ste 300, Fort Wayne, IN 46845 Phone: 260-490-7111 Fax: 260-490-2286 | |
Kevin L Berning, MD Plastic Surgery Medicare: Accepting Medicare Assignments Practice Location: 11141 Parkview Plaza Dr Ste 300, Fort Wayne, IN 46845 Phone: 260-490-7111 Fax: 260-490-2286 | |
Geoffrey M Randolph, MD Plastic Surgery Medicare: Not Enrolled in Medicare Practice Location: 11141 Parkview Plaza Dr Ste 300, Fort Wayne, IN 46845 Phone: 260-490-7111 Fax: 260-490-9301 | |
Albert M Morrison, MD Plastic Surgery Medicare: Medicare Enrolled Practice Location: 11141 Parkview Plaza Dr Ste 300, Fort Wayne, IN 46845 Phone: 260-425-6960 Fax: 260-425-6965 | |
James R. Miller, M.D. Plastic Surgery Medicare: Medicare Enrolled Practice Location: 11141 Parkview Plaza Dr, Suite 305, Fort Wayne, IN 46845 Phone: 260-266-8900 Fax: 260-266-8935 |