Individual
RICHARD W DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1627 SEYMOUR DR, SOUTH BOSTON, VA 24592-3428
(434) 517-0611
(434) 572-6675
Mailing address
1627 SEYMOUR DR, SOUTH BOSTON, VA 24592-3428
(434) 517-0611
(434) 572-6675
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101044667
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110164769
RR/MED
—
01
—
241669
BV/BS
—
05
—
605634-2
—
VA
Enumeration date
08/11/2005
Last updated
09/15/2010
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