Provider Demographics
NPI:1457383002
Name:DAVIDSON, HARLEY EDWARD (PHARMD MPH)
Entity Type:Individual
Prefix:DR
First Name:HARLEY
Middle Name:EDWARD
Last Name:DAVIDSON
Suffix:
Gender:M
Credentials:PHARMD MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 DUKE ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510-1515
Mailing Address - Country:US
Mailing Address - Phone:757-625-6040
Mailing Address - Fax:757-625-6040
Practice Address - Street 1:740 DUKE ST
Practice Address - Street 2:SUITE 120
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-1515
Practice Address - Country:US
Practice Address - Phone:757-625-6040
Practice Address - Fax:757-625-6040
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02020105891835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy