Provider Demographics
NPI:1609163328
Name:DAVIS, ARETHA DELIGHT (ARETHA DELIGHT DAVIS)
Entity Type:Individual
Prefix:DR
First Name:ARETHA
Middle Name:DELIGHT
Last Name:DAVIS
Suffix:
Gender:F
Credentials:ARETHA DELIGHT DAVIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 CARLTON RD
Mailing Address - Street 2:
Mailing Address - City:WABAN
Mailing Address - State:MA
Mailing Address - Zip Code:02468-1825
Mailing Address - Country:US
Mailing Address - Phone:914-539-1801
Mailing Address - Fax:
Practice Address - Street 1:300 MOUNT AUBURN ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138
Practice Address - Country:US
Practice Address - Phone:617-499-5140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-01
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA248612207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine