Provider Demographics
NPI:1457332736
Name:WESLEYAN UNIVERSITY - DAVISON HEALTH CENTER
Entity Type:Organization
Organization Name:WESLEYAN UNIVERSITY - DAVISON HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTER. V.P. FOR FINANCE AND TREASUR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MEERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-685-2607
Mailing Address - Street 1:327 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06459-3232
Mailing Address - Country:US
Mailing Address - Phone:860-685-2470
Mailing Address - Fax:860-685-2471
Practice Address - Street 1:327 HIGH ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06459-3232
Practice Address - Country:US
Practice Address - Phone:860-685-2470
Practice Address - Fax:860-685-2471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0016261QS1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health