# GARY M. DAVIDSON, MD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750451381
- **Authorized official:** GARY M DAVIDSON MD (PHYSICIAN)
- **Authorized official phone:** (814) 479-4034

## Contact information

- **Practice address:** 207 WOODSTOWN HWY, HOLLSOPPLE, PA 15935-7119
- **Practice address phone:** (814) 479-4034
- **Practice address fax:** (814) 479-7166
- **Mailing address:** 207 WOODSTOWN HWY, HOLLSOPPLE, PA 15935-7119
- **Mailing address phone:** (814) 479-4034
- **Mailing address fax:** (814) 479-7166

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | MD040789L | PA | Yes |

## Other

- **Enumeration date:** 11/09/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0011635930006 | — | PA |
| 01 | — | 444015 | HIGHMARK | PA |