Provider Demographics
NPI:1235198979
Name:DAVIS, CAROLYN F (MD)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:F
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 37174
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3174
Mailing Address - Country:US
Mailing Address - Phone:571-423-5699
Mailing Address - Fax:571-423-5698
Practice Address - Street 1:3300 GALLOWS RD
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-3307
Practice Address - Country:US
Practice Address - Phone:703-776-4001
Practice Address - Fax:703-776-7113
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101048048207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1053714OtherUNHC
540894297OtherGW ONE HEALTH
VA6211917Medicaid
502419OtherNCPPO
540894297OtherPHCS
0477529OtherAETNA HMO
317321OtherALLIANCE
34300006OtherBCBS OF DC
440159OtherANTHEM
540894297OtherMAILHANDLERS
206638OtherMDIPA OPTIMUM
4303326OtherAETNA
0101048048OtherVA LICENSE
6213088002OtherCIGNA
6213088002OtherCIGNA