Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 77990 | MA |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 10781 | NH |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 77990 | MA |
NPI | 1154374890 |
---|---|
Provider Name | Karen Davidson |
First Address | Brookline, MA 02445-6007 |
Second Address | Boston, MA 02115-6110 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 29/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3072785 | (05) | NH |