Davis, Kenneth Robert
Davis, Kenneth Robert is an individual health care provider with primary practice located at 55 Fruit St Grb 2 Radiological Associates, Boston MA 02114-2696. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Nuclear Medicine, Allopathic & Osteopathic Physicians / Neuroradiology. Allopathic & Osteopathic Physicians / Nuclear Medicine is his primary health care specialty. Davis, Kenneth Robert can be contacted via phone (617) 726-8757.Contact Information
Primary practice address
55 Fruit St Grb 2 Radiological Associates
Boston MA 02114-2696
Phone: (617) 726-8757
Fax: (617) 724-3338
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nuclear Medicine | 207U00000X | 35398 | Massachusetts |
| Allopathic & Osteopathic Physicians / Neuroradiology | 2085N0700X | 35398 | Massachusetts |
Profile Details
| NPI number | 1669453486 |
|---|---|
| LBN Legal business name | Davis, Kenneth Robert |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 9th, 2005 |
| Last updated | Jul 13th, 2026 - about 3 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669453486 | NPPES |
| Massachusetts | Other | 035398 | TUFTS HEALTH PLAN |
| Massachusetts | Other | M08609 | TUFTS HEALTH PLAN |
| Massachusetts | MEDICAID | 2084864 | TUFTS HEALTH PLAN |
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