Individual
JESSICA M. DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
111 S 11TH ST, PHILADELPHIA, PA 19107-4824
(215) 595-5652
(215) 923-9519
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPARTMENT, ROCKLAND, DE 19732-0191
(904) 697-5062
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
241647
MA
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
ME454991
PA
Other
Enumeration date
06/25/2009
Last updated
10/19/2021
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