Provider Demographics
NPI:1538645023
Name:COLVIN, DONOVAN
Entity Type:Individual
Prefix:MR
First Name:DONOVAN
Middle Name:
Last Name:COLVIN
Suffix:
Gender:M
Credentials:
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 3721
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21217-0721
Mailing Address - Country:US
Mailing Address - Phone:443-531-0282
Mailing Address - Fax:
Practice Address - Street 1:2200 PARK AVE APT C1
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21217-4997
Practice Address - Country:US
Practice Address - Phone:443-531-0282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-17
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)