Individual
JONATHAN E DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3800 RESERVOIR RD NW, WASHINGTON, DC 20007-2113
(202) 444-2119
Mailing address
PO BOX 631872, BALTIMORE, MD 21263-1872
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
33464
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
034148200
—
DC
05
—
510909400
—
MD
01
—
75859902
BLUE SHIELD
MD
01
—
J8790001
BLUE SHIELD
DC
01
—
P00129709
RAILROAD MED
DC
Enumeration date
07/13/2005
Last updated
04/24/2012
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