Individual
MARK DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
743 SPRING ST NE, GAINESVILLE, GA 30501-3715
(770) 532-7179
Mailing address
PO BOX 1076, GAINESVILLE, GA 30503-1076
(770) 532-7179
(770) 534-1312
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
059142
GA
207L00000X
Anesthesiology Physician
Primary
26145
AL
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
059142
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
233277608A
—
GA
05
—
233277608B
—
GA
Enumeration date
05/02/2007
Last updated
03/29/2012
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