Healthcare Provider Details

I. General information

NPI: 1417585886
Provider Name (Legal Business Name): REBECCA MARIE DAVIS DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2020
Last Update Date: 08/15/2023
Certification Date: 08/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 ALLEGHENY AVE STE 101
OAKMONT PA
15139-2072
US

IV. Provider business mailing address

333 ALLEGHENY AVE STE 101
OAKMONT PA
15139-2072
US

V. Phone/Fax

Practice location:
  • Phone: 412-767-5387
  • Fax:
Mailing address:
  • Phone: 412-767-5387
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS022929
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: