MEDICARE: DR. PHILIP AARON DAVENPORT 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	2084N0400X	Neurology Physician	2009-02034	NC
2	2084N0400X	Neurology Physician	0101052402	VA

Other Identifiers

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

General Provider Information

NPI Number	:	1659342806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHILIP AARON DAVENPORT M.D.

Provider Business Mailing Address
First Line	:	301 RIVERVIEW AVE STE 202
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23510-1065
Country	:	US
Telephone Number	:	757-252-9015
Fax Number	:	757-510-9041

Provider Business Practice Location Address
First Line	:	301 RIVERVIEW AVE STE 202
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23510-1065
Country	:	US
Telephone Number	:	757-252-9015
Fax Number	:	757-510-9041

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

Provider Enumeration Date	:	01/27/2006
Last Update Date	:	06/11/2024

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Directions to “ DR. PHILIP AARON DAVENPORT M.D.” Practice Location

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