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NPI Code Detail

MEDICARE: MR. PETER MARK DAVEY JR. PA-C

MEDICARE: MR. PETER MARK DAVEY JR. PA-C
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
1261QP2300XPrimary Care Clinic/Center

General Provider Information

NPI Number : 1275069841
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. PETER MARK DAVEY JR. PA-C
Provider Business Mailing Address
First Line : 8 TURNHAM CT
Second Line :
City : GAITHERSBURG
State : MD
Zip : 20878-2673
Country : US
Telephone Number : 912-306-0991
Fax Number :
Provider Business Practice Location Address
First Line : 1650 17TH ST NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20009-2434
Country : US
Telephone Number : 202-757-2482
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2017
Last Update Date : 03/11/2026

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