Individual
MISS STEPHANIE MARIE DAVIDUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
915 OLD FERN HILL RD STE 202, WEST CHESTER, PA 19380-3431
(610) 692-4270
(610) 692-2566
Mailing address
915 OLD FERN HILL RD STE 202, WEST CHESTER, PA 19380-3431
(610) 692-4270
(610) 692-2566
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA058587
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50145502
CAPITAL BLUE CROSS
PA
Enumeration date
09/29/2016
Last updated
10/08/2018
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