Individual
MARK DAVIDOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
65 W JIMMIE LEEDS RD, POMONA, NJ 08240-9102
(609) 748-7597
Mailing address
65 W JIMMIE LEEDS RD, POMONA, NJ 08240-9102
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25MA09263200
NJ
207L00000X
Anesthesiology Physician
4301097628
MI
Other
Enumeration date
09/25/2008
Last updated
08/25/2013
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