Michael Benjamin Davidson, DO

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

13393 Issued in NH

Practice address

10 Members Way
Suite 400
Dover, NH 03820-5933

Phone

(603) 742-1143

Fax

(603) 749-3509

NPI assigned

Nov 13, 2006

Last updated

Feb 17, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392595200000",
    "number": "1225109168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "789 CENTRAL AVE",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202526",
            "telephone_number": "603-742-1143",
            "fax_number": "603-749-3509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MEMBERS WAY",
            "address_2": "SUITE 400",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038205933",
            "telephone_number": "603-742-1143",
            "fax_number": "603-749-3509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "MICHAEL",
        "middle_name": "BENJAMIN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2014-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NH",
            "license": "13393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3076450",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00775096",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225109168",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Daudelin, MSW
• Leigh K Davenport, RD, LD
• David B Staples DDS & Nicholas Kanelos Jr DMD
• David Ieni DDS Family Dental PLLC
• David J. Corriss, PH.D., PLLC
• Emily Sara Davie, MD
• Elisabeth J Davis, APRN
• Leland Terrell Davis III, PA-C
• Meredith Davis, CNM
• Daniel R Dawson, D.C.

• Endocrinology, Diabetes & Metabolism Physician in Dover, NH
• Providers in Dover, NH by specialty
• Endocrinology, Diabetes & Metabolism Physician in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.