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MR. KEVAN EDWARD DAVENPORT PA-C
Medical >> Physician Assistant >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1184685794
Individual Registrant:MR. KEVAN EDWARD DAVENPORT PA-C
Gender: M
Sole Proprietor
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: --
Tel: 410-477-1800 Fax: --
Contact information for business:
9517 ANGELINA CIR COLUMBIA, MD 21045-5114 US
Tel: 410-477-1800 Fax: --
Tel: 410-477-1800 Fax: --
Registration Information:
NPI: 1184685794
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363AM0700X | Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Medical | MD | C0000839 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
