Healthcare Provider Details

I. General information

NPI: 1164585402
Provider Name (Legal Business Name): HEATHER E DAVIES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 04/22/2021
Certification Date: 04/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9901 MEDICAL CENTER DR FL 3
ROCKVILLE MD
20850-3357
US

IV. Provider business mailing address

10028 WEATHERWOOD CT
POTOMAC MD
20854-2137
US

V. Phone/Fax

Practice location:
  • Phone: 240-826-7392
  • Fax: 240-826-5388
Mailing address:
  • Phone: 240-403-7417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD008769
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35084152
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberD0068769
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: