Provider Demographics
NPI:1548231731
Name:HAVLIN, DAVID N (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:N
Last Name:HAVLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:55 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:WINCHENDON
Mailing Address - State:MA
Mailing Address - Zip Code:01475-1820
Mailing Address - Country:US
Mailing Address - Phone:978-297-2311
Mailing Address - Fax:978-297-4173
Practice Address - Street 1:55 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:WINCHENDON
Practice Address - State:MA
Practice Address - Zip Code:01475-1279
Practice Address - Country:US
Practice Address - Phone:978-297-2311
Practice Address - Fax:978-297-4173
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-27
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA56212207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3008568Medicaid
MA3008568Medicaid