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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215159025 NPPES
Georgia MEDICAID 233277608A
Georgia MEDICAID 233277608B

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