Provider Demographics
NPI:1407992167
Name:DAVIDSON, SASHA M (MD)
Entity Type:Individual
Prefix:DR
First Name:SASHA
Middle Name:M
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 E LAS OLAS BLVD STE 130-415
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-2210
Mailing Address - Country:US
Mailing Address - Phone:954-603-3933
Mailing Address - Fax:954-603-3939
Practice Address - Street 1:2151 E COMMERCIAL BLVD STE 202
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-3807
Practice Address - Country:US
Practice Address - Phone:954-603-3933
Practice Address - Fax:954-603-3939
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0067862207V00000X
DCMD037119207V00000X
IN01079464A207VM0101X
FLME127647207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology