Healthcare Provider Details
I. General information
NPI: 1134583727
Provider Name (Legal Business Name): ERICA RENEE DAVENPORT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/08/2016
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
920 E HIGH ST STE 201
CHARLOTTESVILLE VA
22902-4850
US
IV. Provider business mailing address
13710 ST FRANCIS BLVD
MIDLOTHIAN VA
23114-3267
US
V. Phone/Fax
- Phone: 434-654-2870
- Fax: 833-954-5530
- Phone: 804-320-2483
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | D0092091 |
| License Number State | MD |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | MD047999 |
| License Number State | DC |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | 0101272374 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: