Individual
MR. KEVAN EDWARD DAVENPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
9600 N POINT RD, FORT HOWARD, MD 21052-3050
(410) 477-1800
Mailing address
9517 ANGELINA CIR, COLUMBIA, MD 21045-5114
(410) 477-1800
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C0000839
MD
Other
Enumeration date
03/31/2006
Last updated
01/20/2011
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