Healthcare Provider Details

I. General information

NPI: 1740290691
Provider Name (Legal Business Name): DAVID SAVAGE PA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

74 ROUND POND DR
EAST FALMOUTH MA
02536-4737
US

IV. Provider business mailing address

74 ROUND POND DR
EAST FALMOUTH MA
02536-4737
US

V. Phone/Fax

Practice location:
  • Phone: 508-540-9381
  • Fax:
Mailing address:
  • Phone: 508-540-9381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number195
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: