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NPI Code Detail

MEDICARE: GARY M DAVIDSON MD

MEDICARE: GARY M DAVIDSON MD
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
1207QA0505XAdult Medicine Physician0101250753VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609872993
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARY M DAVIDSON MD
Provider Business Mailing Address
First Line : 8109 HINSON FARM RD
Second Line : SUITE 504
City : ALEXANDRIA
State : VA
Zip : 22306-3415
Country : US
Telephone Number : 703-780-2800
Fax Number : 703-780-0461
Provider Business Practice Location Address
First Line : 8109 HINSON FARM RD
Second Line : SUITE 504
City : ALEXANDRIA
State : VA
Zip : 22306-3415
Country : US
Telephone Number : 703-780-2800
Fax Number : 703-780-0461
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 10/20/2011

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