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Individual

DR. DAVID WALTER CASAVANT

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
55 FRUIT ST, ELL 317, BOSTON, MA 02114-2621
(617) 724-4380
Mailing address
PO BOX 9142, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
155793
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
155793
TUFTS HEALTH PLAN
MA
05
3183947
MA
01
J18840
BCBS MA
MA
Enumeration date
11/07/2005
Last updated
07/08/2007
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