Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 14303 | MA |
Y | 213EG0000X | General Practice | 14303 | MA |
NPI | 1003903055 |
---|---|
Provider Name | Dr. David William Archibald |
First Address | Groveland, MA 01834-1311 |
Second Address | Groveland, MA 01834-1311 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2006 |
Last Update Date | 08/07/2007 |