Individual
DR. EDDIE DEAN DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4881 SUGAR MAPLE DR, WRIGHT PATTERSON AFB, OH 45433
(937) 938-2752
Mailing address
4881 SUGAR MAPLE DR, WRIGHT PATTERSON AFB, OH 45433-5529
(937) 257-1558
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
48089
WI
207RC0000X
Cardiovascular Disease Physician
Primary
35.097215
OH
207RC0000X
Cardiovascular Disease Physician
N3601
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0054374
—
OH
Enumeration date
08/30/2006
Last updated
08/09/2019
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