Basic Information
| Provider Information | |||||||||
| NPI: | 1316912991 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COVINGTON | ||||||||
| FirstName: | DAMIAN | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | M. D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1510 N 28TH ST | ||||||||
| Address2: | STE 300 | ||||||||
| City: | RICHMOND | ||||||||
| State: | VA | ||||||||
| PostalCode: | 232235311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8042257177 | ||||||||
| FaxNumber: | 8042257176 | ||||||||
| Practice Location | |||||||||
| Address1: | 11020 HULL STREET RD | ||||||||
| Address2: | |||||||||
| City: | MIDLOTHIAN | ||||||||
| State: | VA | ||||||||
| PostalCode: | 231123200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8047446310 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/17/2006 | ||||||||
| LastUpdateDate: | 03/24/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/24/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 0101227874 | VA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.