Individual
DR. DEBORAH A DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3625 W 65TH ST, SUITE 100, EDINA, MN 55435-2106
(952) 920-7001
(952) 920-2245
Mailing address
3625 W 65TH ST, SUITE 100, EDINA, MN 55435-2106
(952) 920-7001
(952) 920-2245
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
30600
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0716969
MEDICA
MN
01
—
19225DA
BCBS
MN
05
—
619393500
—
MN
Enumeration date
08/08/2006
Last updated
09/15/2011
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