Healthcare Provider Details

I. General information

NPI: 1730490186
Provider Name (Legal Business Name): TRAMAINE ANGELA DAVIS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2010
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15459 ANNAPOLIS RD
BOWIE MD
20715-1847
US

IV. Provider business mailing address

9612 WOODBERRY ST
SEABROOK MD
20706-3608
US

V. Phone/Fax

Practice location:
  • Phone: 240-544-0676
  • Fax: 240-544-0677
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD0076248
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: