Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | MD458124 | PA |
N | 207RH0003X | Hematology & Oncology | 35041156D | OH |
NPI | 1548224991 |
---|---|
Provider Name | Mellar P Davis |
First Address | Danville, PA 17822-4903 |
Second Address | Danville, PA 17822-0140 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2006 |
Last Update Date | 31/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0517819 | (05) | OH |
C02543 | (02) | OH |