Individual
DR. DAVID P GANNON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
68 N MAIN ST, CARVER, MA 02330-1128
(508) 747-7246
(508) 747-7256
Mailing address
68 N MAIN ST STE A125, CARVER, MA 02330-1128
(508) 747-7246
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
50303
MA
207R00000X
Internal Medicine Physician
50303
MA
208VP0014X
Interventional Pain Medicine Physician
50303
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3001091
—
MA
01
—
AA124352
HARVARD PILGRIM HEALTH CARE
MA
Enumeration date
07/21/2005
Last updated
04/24/2024
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