Individual
DAVID CONWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
40 HOLLAND ST, SOMERVILLE, MA 02144-2705
(617) 629-6280
(617) 629-6275
Mailing address
147 MILK ST, PROVIDER ENROLLMENT - 9TH FLOOR, BOSTON, MA 02109-4806
(617) 421-2508
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3109
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005127
NHP
MA
05
—
0354171
—
MA
01
—
2277754-002
CIGNA
MA
01
—
797076
TUFTS
MA
01
—
HV0063
HPHC
MA
01
—
W16183
BCBS
MA
Enumeration date
12/28/2006
Last updated
07/07/2011
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