Individual
ALEXANDRIA DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(267) 595-7437
Mailing address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA061767
PA
363AS0400X
Surgical Physician Assistant
25MP00579400
NJ
363AS0400X
Surgical Physician Assistant
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Other
Enumeration date
07/06/2020
Last updated
04/24/2024
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