Provider Demographics
NPI:1144433285
Name:DAVIS, ROBERT HUGH (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:HUGH
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6125 STEPHENS XING
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-2371
Mailing Address - Country:US
Mailing Address - Phone:717-790-9163
Mailing Address - Fax:717-766-6537
Practice Address - Street 1:6125 STEPHENS XING
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-2371
Practice Address - Country:US
Practice Address - Phone:717-790-9163
Practice Address - Fax:717-766-6537
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD017887E2084F0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0550903Medicaid