Provider Demographics
NPI:1972712917
Name:DAVIS, SANDRA JO (MD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:JO
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:JO
Other - Last Name:KAPLAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4608 WILLARD AVE
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-4606
Mailing Address - Country:US
Mailing Address - Phone:301-986-2989
Mailing Address - Fax:301-986-2801
Practice Address - Street 1:4608 WILLARD AVE
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-4606
Practice Address - Country:US
Practice Address - Phone:301-986-2989
Practice Address - Fax:301-986-2801
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD31983207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine