Healthcare Provider Details

I. General information

NPI: 1114954153
Provider Name (Legal Business Name): NANCY ELLEN DAVIDSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 02/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 LOTHROP ST
PITTSBURGH PA
15213-2536
US

IV. Provider business mailing address

200 LOTHROP ST SUITE 9055 FORBES TOWER
PITTSBURGH PA
15213-2536
US

V. Phone/Fax

Practice location:
  • Phone: 412-623-3205
  • Fax: 412-623-3210
Mailing address:
  • Phone: 412-647-3087
  • Fax: 412-647-4486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberD28239
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: