Gerard M Davidson, DO
Family Medicine in Dyer, IN. Individual provider (NPI-1).
NPI number1689666240
StatusActive
Last updated in NPPESMay 3, 2023
Details
- NPI
- 1689666240
- Entity type
- Individual (NPI-1)
- Name
- Gerard M Davidson
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 19, 2005
- Certification date
- May 3, 2023
- Last updated
- May 3, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - FAMILY PRACTICE
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 02000745A | IN | Yes |
Practice location
840 Richard Rd Ste 2Dyer, IN 46311-1994
Phone 219-322-1450 · Fax 219-322-8260
Mailing address
Po Box 781076Detroit, MI 48278-1076
Phone 317-528-4800 · Fax 317-865-1479
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 19 Family Medicine Physician providers in Dyer · All 621 providers in Dyer
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