Provider Demographics
NPI:1609033232
Name:DAVIES, GARETH (MD)
Entity Type:Individual
Prefix:
First Name:GARETH
Middle Name:
Last Name:DAVIES
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 1:330 BORTHWICK AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-4174
Mailing Address - Country:US
Mailing Address - Phone:603-433-4666
Mailing Address - Fax:603-433-1338
Practice Address - Street 1:330 BORTHWICK AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-4174
Practice Address - Country:US
Practice Address - Phone:603-433-4666
Practice Address - Fax:603-433-1338
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT192538207T00000X
NH17105207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHP01530333OtherRAILROAD MEDICARE
NH3103303Medicaid
NHT400244073Medicare PIN