NPI 1083623912 · live from the CMS NPI Registry
Robert R Davidson, PA-C
Physician Assistant in Berlin, VT. National Provider Identifier 1083623912, active.
NPI record
| NPI | 1083623912 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 130 Fisher Rd, Berlin, VT 05602 |
| Practice phone | 802-225-7000 |
| Mailing address | 14 N Pinnacle Ridge Rd, Waterbury, VT 05676 |
| Enumerated | August 7, 2006 |
| Last updated | July 8, 2007 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant primary | 363A00000X | 550030361 (VT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.