Provider Demographics
NPI:1679557128
Name:DAVIS, RODERICK GARFIELD (MD)
Entity type:Individual
Prefix:DR
First Name:RODERICK
Middle Name:GARFIELD
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1700 HUDSON AVENUE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617
Mailing Address - Country:US
Mailing Address - Phone:585-342-5694
Mailing Address - Fax:585-342-2345
Practice Address - Street 1:1700 HUDSON AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14617-5104
Practice Address - Country:US
Practice Address - Phone:585-342-5694
Practice Address - Fax:585-342-2345
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY207792-1208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics