NPI 1083623912

Robert R Davidson, PAC

Practitioner Physician Assistant Berlin, VT

Practice location

Address: 130 Fisher Rd, Berlin, VT 05602-9516
Phone: (802) 225-7000
Mailing address: 14 N Pinnacle Ridge Rd, Waterbury, VT 05676-9140

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 550030361 (VT)

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Registry record

NPI: 1083623912
Entity type: Individual
Sex (as registered): Male
NPI issued: 7 Aug 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.