Basic Information
| Provider Information | |||||||||
| NPI: | 1164585402 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DAVIES | ||||||||
| FirstName: | HEATHER | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10028 WEATHERWOOD CT | ||||||||
| Address2: | |||||||||
| City: | POTOMAC | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208542137 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2404037417 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9901 MEDICAL CENTER DR FL 3 | ||||||||
| Address2: | |||||||||
| City: | ROCKVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208503357 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2408267392 | ||||||||
| FaxNumber: | 2408265388 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/18/2006 | ||||||||
| LastUpdateDate: | 04/22/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | D008769 | MD | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | 35084152 | OH | N | Allopathic & Osteopathic Physicians | Pediatrics | 208M00000X | D0068769 | MD | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.