Provider Demographics
NPI:1558690230
Name:DAVIS, HAROLD MATTHEW (MD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:MATTHEW
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 HUDSON ST
Mailing Address - Street 2:UNIT 10G
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-5590
Mailing Address - Country:US
Mailing Address - Phone:201-683-8261
Mailing Address - Fax:
Practice Address - Street 1:1500 HUDSON ST
Practice Address - Street 2:UNIT 10G
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-5590
Practice Address - Country:US
Practice Address - Phone:201-683-8261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-09
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA0491690207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine