Individual
DR. RUSSELL O DAVIS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2480 LLEWELLYN AVE, FORT MEADE, MD 20755-7081
(301) 677-8969
Mailing address
802 FAIRRIDGE DR, CROWNSVILLE, MD 21032-2324
(301) 677-8092
(301) 677-8820
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
HOO69049
MD
207R00000X
Internal Medicine Physician
MD31454
DC
Other
Enumeration date
10/03/2006
Last updated
04/26/2024
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