Healthcare Provider Details

I. General information

NPI: 1457348930
Provider Name (Legal Business Name): DAVID C MOVERMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 11/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2005 BAY ST STE 206
TAUNTON MA
02780-1085
US

IV. Provider business mailing address

2005 BAY ST STE 206
TAUNTON MA
02780-1085
US

V. Phone/Fax

Practice location:
  • Phone: 508-823-7473
  • Fax: 508-824-3830
Mailing address:
  • Phone: 508-823-7473
  • Fax: 508-824-3830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License Number59067
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number59067
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: