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Individual

JOHN DAVIES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
133 BROOKLINE AVE, BOSTON, MA 02215-3904
(617) 421-1000
Mailing address
147 MILK ST, BOSTON, MA 02109-4806

Taxonomy

Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
35008
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0014436
NHP
MA
05
3182860
MA
01
6099412-002
CIGNA
MA
01
796018
TUFTS
MA
01
B218
HPHC
MA
01
M08963
BCBS
MA
Enumeration date
12/26/2006
Last updated
07/08/2007
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