Individual
MR. LEAMON L. DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
30 MEDICAL CENTER BLVD, SUITE 205, UPLAND, PA 19013-3955
(610) 619-7410
(610) 876-8483
Mailing address
30 MEDICAL CENTER BLVD, SUITE 205, UPLAND, PA 19013-3955
(610) 619-7410
(610) 876-8483
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A123303
NM
208000000X
Pediatrics Physician
MB08546500
NJ
208000000X
Pediatrics Physician
Primary
OS017399
PA
208M00000X
Hospitalist Physician
MB08546500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43670083
—
NM
05
—
807919
—
AZ
Enumeration date
03/24/2006
Last updated
05/27/2015
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