Organization
GARY M. DAVIDSON, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY M DAVIDSON MD (PHYSICIAN)
(814) 479-4034
Entity
Organization
Contact information
Practice address
207 WOODSTOWN HWY, HOLLSOPPLE, PA 15935-7119
(814) 479-4034
(814) 479-7166
Mailing address
207 WOODSTOWN HWY, HOLLSOPPLE, PA 15935-7119
(814) 479-4034
(814) 479-7166
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD040789L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011635930006
—
PA
01
—
444015
HIGHMARK
PA
Enumeration date
11/09/2006
Last updated
08/22/2020
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