Provider Demographics
NPI:1497829196
Name:DAVIDSON, PATRICIA (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:
Last Name:DAVIDSON
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 1:106 IRVING ST NW
Mailing Address - Street 2:SUITE 118
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2994
Mailing Address - Country:US
Mailing Address - Phone:202-877-3000
Mailing Address - Fax:202-877-3860
Practice Address - Street 1:106 IRVING ST NW
Practice Address - Street 2:SUITE 118
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2994
Practice Address - Country:US
Practice Address - Phone:202-877-3000
Practice Address - Fax:202-877-3860
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD12134207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCC89299Medicare UPIN
DC518963Medicare PIN