Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Michael Robert Davis, MD

Individual provider Plastic Surgery Physician · NPI 1477622934

Dr. Michael Robert Davis, MD is a Plastic and Reconstructive Surgery in Fort Wayne, Indiana. Qualified in 1998, 28 years ago. Practices with South Texas Aesthetic and Reconstructive Surgery PLLC, a 5-clinician group and accepts Medicare assignment. Licensed in Alabama, Indiana and Texas.

Years since qualifying
28
Licensed in
AL, IN, TX
In the registry since
2006
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

7900 W Jefferson Blvd Ste 306
Fort Wayne, IN 46804-4128
Phone: (260) 458-3610
Fax: (260) 458-3611
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic Surgery Physician (primary) Taxonomy 208200000X · Licence 01053296A (IN)
Plastic Surgery Physician Taxonomy 208200000X · Licence 26620 (AL)
Plastic Surgery Physician Taxonomy 208200000X · Licence P1857 (TX)

Record details

NPI number1477622934
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedNovember 7, 2006
Last updated in NPPESApril 19, 2018
Mailing address6920 Pointe Inverness Way Ste 200, Fort Wayne, IN 46804-7934

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPLASTIC AND RECONSTRUCTIVE SURGERY
Medical schoolOTHER
Graduated 1998 (28 years in practice)
Group practice South Texas Aesthetic And Reconstructive Surgery Pllc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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