Dr. Russell O Davis III, DO
Internal Medicine in Fort Meade, MD. Individual provider (NPI-1).
NPI number1154416618
StatusActive
Last updated in NPPESApr 26, 2024
Details
- NPI
- 1154416618
- Entity type
- Individual (NPI-1)
- Name
- Dr. Russell O Davis III
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 3, 2006
- Certification date
- Apr 26, 2024
- Last updated
- Apr 26, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | HOO69049 | MD | Yes |
| 207R00000X | Internal Medicine | MD31454 | DC |
Practice location
2480 Llewellyn AveFort Meade, MD 20755-7081
Phone 301-677-8969
Mailing address
802 Fairridge DrCrownsville, MD 21032-2324
Phone 301-677-8092 · Fax 301-677-8820
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