Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | 35008 | MA |
NPI | 1144385543 |
---|---|
Provider Name | John Davies |
First Address | Boston, MA 02109-4806 |
Second Address | Boston, MA 02215-3904 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0014436 | NHP (01) | MA |
3182860 | (05) | MA |
6099412-002 | CIGNA (01) | MA |
796018 | TUFTS (01) | MA |
B218 | HPHC (01) | MA |
B75918 | (02) | MA |
M08963 | BCBS (01) | MA |