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MR. KEVAN EDWARD DAVENPORT PA-C

Medical >> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1184685794

Individual Registrant:
MR. KEVAN EDWARD DAVENPORT PA-C
Gender: M
Sole Proprietor

Location and contact information for practice:
9600 N POINT RD  FORT HOWARD, MD 21052-3050 US
Tel: 410-477-1800  Fax: --

Contact information for business:
9517 ANGELINA CIR  COLUMBIA, MD 21045-5114 US
Tel: 410-477-1800  Fax: --

Registration Information:
NPI: 1184685794
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363AM0700XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
Medical
MDC0000839

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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