Healthcare Provider Details

I. General information

NPI: 1225967003
Provider Name (Legal Business Name): DAVIA LISANDRA MARSHALL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 WEST CHEW STREET SUITE 203
ALLENTOWN PA
18102-3434
US

IV. Provider business mailing address

1700 ST LUKES BLVD
EASTON PA
18045-5670
US

V. Phone/Fax

Practice location:
  • Phone: 484-822-7850
  • Fax: 833-691-7856
Mailing address:
  • Phone: 484-822-7850
  • Fax: 833-691-7856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMT236935
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: