Provider Demographics
NPI:1558362939
Name:DAVIS, HARVEY D (MD)
Entity Type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:D
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1704 SIR WILLIAM OSLER DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-3003
Mailing Address - Country:US
Mailing Address - Phone:757-481-4383
Mailing Address - Fax:757-481-4611
Practice Address - Street 1:1704 SIR WILLIAM OSLER DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-3003
Practice Address - Country:US
Practice Address - Phone:757-481-4383
Practice Address - Fax:757-481-4611
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101021155207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6046380Medicaid
B07867Medicare UPIN