Davis, Russell O
Davis, Russell O is an individual health care provider with primary practice located at 2480 Llewellyn Ave , Fort Meade MD 20755-7081. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Davis, Russell O can be contacted via phone (301) 677-8969.Contact Information
Primary practice address
2480 Llewellyn Ave
Fort Meade MD 20755-7081
Phone: (301) 677-8969
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | HOO69049 | Maryland |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MD31454 | District of Columbia |
Profile Details
| NPI number | 1154416618 |
|---|---|
| LBN Legal business name | Davis, Russell O |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 3rd, 2006 |
| Last updated | Apr 26th, 2024 - about last year |
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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