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General NPI Number Information
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NPI Number | 1447285648
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Entity Type | Individual
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Provider Name | SANDIE VAUGH DAVIS PA
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Gender | Female
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 15001 HEALTH CENTER DRIVE BOWIE HEALTH CENTER
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City | BOWIE
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State | MD
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Zip | 20716
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Country | US
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Telephone | 301-262-6150
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Fax | 610-617-6280
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Provider Business Mailing Address
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Address Line | PO BOX 1780 DIMENSIONS HEALTH CORPORATION
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City | BOWIE
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State | MD
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Zip | 20716-0780
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Country | US
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Telephone | 800-777-2455
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Fax | 610-617-6280
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C0000459
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License Number State | MD
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