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General NPI Number Information
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NPI Number | 1275970394
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Entity Type | Individual
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Provider Name | CAROLYN DAVIDSON M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/30/2013
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 208 MILL RD
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City | FAIRHAVEN
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State | MA
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Zip | 02719-5208
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Country | US
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Telephone | 508-973-2207
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Fax | 508-973-2505
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Provider Business Mailing Address
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Address Line | 200 MILL RD
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City | FAIRHAVEN
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State | MA
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Zip | 02719-5252
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Country | US
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Telephone | 508-973-2000
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Fax | 508-973-2001
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MD15831
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 20468
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License Number State | NH
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 1020441
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License Number State | MA
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