Individual
KAYE E DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3998 FAIR RIDGE DR, STE 320, FAIRFAX, VA 22033-2907
(703) 295-9360
(703) 295-9369
Mailing address
2326 STUTZ DR UNIT 116, DALLAS, TX 75235-6540
(773) 368-8845
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
0101256976
VA
207L00000X
Anesthesiology Physician
Primary
T0191
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036089197
—
IL
01
—
04932277
BCBS
IL
01
—
P00154997
RAILROAD MEDICARE
IL
Enumeration date
12/05/2006
Last updated
10/05/2022
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