Healthcare Provider Details

I. General information

NPI: 1083552574
Provider Name (Legal Business Name): MARIA DAVIDSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1513 HARRISON AVE STE A2
ELKINS WV
26241-4514
US

IV. Provider business mailing address

53 SMITHFIELD ST
BUCKHANNON WV
26201-2618
US

V. Phone/Fax

Practice location:
  • Phone: 304-242-8404
  • Fax:
Mailing address:
  • Phone: 304-406-2390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: