Davenport, Eddie Dean

Davenport, Eddie Dean is an individual health care provider with primary practice located at 4881 Sugar Maple Dr , Wright Patterson Afb OH 45433. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Davenport, Eddie Dean can be contacted via phone (937) 938-2752.

Contact Information

Primary practice address
4881 Sugar Maple Dr Wright Patterson Afb OH 45433
Phone: (937) 938-2752
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X N3601 Texas
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 48089 Wisconsin
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 35.097215 Ohio

Profile Details

NPI number 1962512210
LBN Legal business name Davenport, Eddie Dean
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2006
Last updated Aug 9th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962512210 NPPES
Ohio MEDICAID 0054374

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