Individual
DR. KENNETH H DAVIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1415 PORTLAND AVE, SUITE 350, ROCHESTER, NY 14621-3038
(585) 426-9278
(585) 338-2738
Mailing address
1415 PORTLAND AVE, SUITE 350, ROCHESTER, NY 14621-3038
(585) 426-9278
(585) 338-2738
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
103663
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00450853
—
NY
01
—
005002871
BLUE SHIELD WESTERN NY
—
01
—
07341
CHOICE CARE
—
01
—
10453
GHI
—
01
—
9913
BLUE CROSS BLUE SHIELD
—
01
—
MD4426
PREFERRED CARE
—
01
—
P010103663
BLUE CHOICE
—
01
—
Y019296
CHAMPUS
—
Enumeration date
02/03/2006
Last updated
10/09/2013
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