Individual
TERRY NORMAN DAVIS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1 MEDICAL CENTER DR, CLARKSBURG, WV 26301
(304) 623-3461
Mailing address
1 MEDICAL CENTER DR, CLARKSBURG, WV 26301
(304) 623-3461
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2503
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1183198
NCCPA
—
01
—
2503
WEST VIRGINIA STATE LICENSE
WV
Enumeration date
07/22/2021
Last updated
08/16/2021
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