Individual
ROBERT R DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
130 FISHER RD, BERLIN, VT 05602-9516
(802) 225-7000
Mailing address
14 N PINNACLE RIDGE RD, WATERBURY, VT 05676-9140
(802) 244-0850
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
550030361
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OAP0864
—
VT
Enumeration date
08/07/2006
Last updated
07/08/2007
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