Healthcare Provider Details

I. General information

NPI: 1841785854
Provider Name (Legal Business Name): DAVID A ARCHER JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2018
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WASON AVE STE 120
SPRINGFIELD MA
01107-1179
US

IV. Provider business mailing address

100 WASON AVE STE 120
SPRINGFIELD MA
01107-1179
US

V. Phone/Fax

Practice location:
  • Phone: 413-241-2100
  • Fax: 413-735-1986
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number1026016
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberBP10063106
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number91577
License Number StateSC
# 4
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number91577
License Number StateSC
# 5
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME141779
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number10063106
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: