Individual
KATHY DAVIS GAUTHIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
75 FRANCIS ST, BOSTON, MA 02115-6110
(617) 732-5500
Mailing address
75 FRANCIS ST, BOSTON, MA 02115-6110
(617) 732-5500
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
1054
CT
363A00000X
Physician Assistant
001054
CT
363A00000X
Physician Assistant
Primary
PA4555
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010504
CONNECTICARE
—
01
—
06-1049086
COMM. HEALTH NETWORK/ECCG
—
01
—
06-1616101
COMM. HEALTH NETWORK/ECCD
—
01
—
290001054CT03
ANTHEM/ECCGH:06-1049086
—
01
—
290001054CT05
ANTHEM/ECCD:06-1616101
—
01
—
2V7414
HEALTHNET/ECCG:06-1049086
—
01
—
2V7415
HELATHNET/ECCD:06-1616101
—
01
—
500HBC444CT01
ANTHEM:HOSP-BASED ECCD
—
Enumeration date
06/12/2006
Last updated
11/18/2016
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