Provider Demographics
NPI:1700861762
Name:DAVIS, HELEN A (MD)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:A
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 BLUE GRASS CIRCLE
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146
Mailing Address - Country:US
Mailing Address - Phone:412-374-8883
Mailing Address - Fax:
Practice Address - Street 1:160 BLUE GRASS CIRCLE
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146
Practice Address - Country:US
Practice Address - Phone:412-374-8883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY291313207W00000X
PAMD040414E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011076920011Medicaid
PA841152OtherBLUE SHIELD
PA001107692008Medicaid
C34729Medicare UPIN
PA0011076920011Medicaid