MEDICARE: DR. DAVIA LISANDRA MARSHALL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	MT236935	PA

General Provider Information

NPI Number	:	1225967003
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVIA LISANDRA MARSHALL MD

Provider Business Mailing Address
First Line	:	1700 ST LUKES BLVD
Second Line	:
City	:	EASTON
State	:	PA
Zip	:	18045-5670
Country	:	US
Telephone Number	:	484-822-7850
Fax Number	:	833-691-7856

Provider Business Practice Location Address
First Line	:	450 WEST CHEW STREET
Second Line	:	SUITE 203
City	:	ALLENTOWN
State	:	PA
Zip	:	18102-3434
Country	:	US
Telephone Number	:	484-822-7850
Fax Number	:	833-691-7856

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2026
Last Update Date	:	05/18/2026

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