Healthcare Provider Details

I. General information

NPI: 1902509995
Provider Name (Legal Business Name): GARETT DAVIES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MEMORIAL AVE
WESTMINSTER MD
21157-5726
US

IV. Provider business mailing address

200 MEMORIAL AVE
WESTMINSTER MD
21157-5726
US

V. Phone/Fax

Practice location:
  • Phone: 410-848-3000
  • Fax:
Mailing address:
  • Phone: 410-848-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD0105653
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101284199
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: