Provider Demographics
NPI:1699202655
Name:GARAS, DAVID (MD)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:GARAS
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 1:10 CENTENNIAL DRIVE
Mailing Address - Street 2:EAST ENTRANCE
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-7938
Mailing Address - Country:US
Mailing Address - Phone:978-826-7230
Mailing Address - Fax:978-826-1058
Practice Address - Street 1:10 CENTENNIAL DRIVE
Practice Address - Street 2:EAST ENTRANCE
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-7938
Practice Address - Country:US
Practice Address - Phone:978-826-7230
Practice Address - Fax:978-826-1058
Is Sole Proprietor?:No
Enumeration Date:2017-05-21
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MA287541207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAS400878752Medicaid