MEDICARE: DR. RANDY FRANK DAVIS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208VP0000X	Pain Medicine Physician	D0024332	MD

General Provider Information

NPI Number	:	1215956529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RANDY FRANK DAVIS M.D.

Provider Business Mailing Address
First Line	:	450 GARRISONVILLE RD STE 109
Second Line	:
City	:	STAFFORD
State	:	VA
Zip	:	22554-1615
Country	:	US
Telephone Number	:	703-522-2727
Fax Number	:	703-542-3753

Provider Business Practice Location Address
First Line	:	3500 BOSTON ST STE J2
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21224-5251
Country	:	US
Telephone Number	:	703-522-2727
Fax Number	:	703-542-3753

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	03/17/2025

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