Provider Demographics
NPI:1962979385
Name:DAVOS, MARINA (PA)
Entity type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:DAVOS
Suffix:
Gender:
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:49 REVOLUTION DR
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-2558
Mailing Address - Country:US
Mailing Address - Phone:978-514-3641
Mailing Address - Fax:
Practice Address - Street 1:81 RESERVOIR DR
Practice Address - Street 2:
Practice Address - City:ATHOL
Practice Address - State:MA
Practice Address - Zip Code:01331-4901
Practice Address - Country:US
Practice Address - Phone:978-248-5135
Practice Address - Fax:978-248-5130
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-24
Last Update Date:2025-03-05
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant