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Individual

CHARISSE CHANTEL DAVENPORT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
8830 BELAIR RD, BALTIMORE, MD 21236-2401
(410) 529-9200
Mailing address
5000 COX RD, GLEN ALLEN, VA 23060-9263
(804) 968-5700

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
H0064558
MD

Other

Enumeration date
09/20/2006
Last updated
03/24/2021
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