Individual
SHANE ROBERT DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1602 SKIPWITH RD, RICHMOND, VA 23229-5205
(301) 335-6970
Mailing address
1602 SKIPWITH RD, RICHMOND, VA 23229-5205
(301) 335-6970
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101266115
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/03/2017
Last updated
06/30/2020
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