Davidson, Mark
Davidson, Mark is an individual health care provider with primary practice located at 743 Spring St Ne , Gainesville GA 30501-3715. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Anesthesiology. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Davidson, Mark can be contacted via phone (770) 532-7179.Contact Information
Primary practice address
743 Spring St Ne
Gainesville GA 30501-3715
Phone: (770) 532-7179
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207LC0200X | 059142 | Georgia |
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 059142 | Georgia |
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 26145 | Alabama |
Profile Details
| NPI number | 1215159025 |
|---|---|
| LBN Legal business name | Davidson, Mark |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 2nd, 2007 |
| Last updated | Mar 29th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215159025 | NPPES |
| Georgia | MEDICAID | 233277608A | |
| Georgia | MEDICAID | 233277608B |
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