Provider Demographics
NPI:1225036684
Name:DAVIES, PAUL W (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:W
Last Name:DAVIES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:116 DEFENSE HWY
Mailing Address - Street 2:SUITE 403
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7027
Mailing Address - Country:US
Mailing Address - Phone:410-571-2946
Mailing Address - Fax:410-571-2947
Practice Address - Street 1:116 DEFENSE HWY
Practice Address - Street 2:SUITE 403
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7027
Practice Address - Country:US
Practice Address - Phone:410-571-2946
Practice Address - Fax:410-571-2947
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-11
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0059537208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG01835A01Medicare PIN
MDH98060Medicare UPIN
MD690M183FMedicare PIN