Davenport, Mark P

Davenport, Mark P is an individual health care provider with primary practice located at 3601 W Front St , Traverse City MI 49684-8151. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Davenport, Mark P can be contacted via phone (231) 946-1120.

Contact Information

Primary practice address
3601 W Front St Traverse City MI 49684-8151
Phone: (231) 946-1120
Fax: (231) 946-8943
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 4301044971 Michigan

Profile Details

NPI number 1477525632
LBN Legal business name Davenport, Mark P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 2nd, 2006
Last updated Nov 27th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477525632 NPPES
Michigan MEDICAID 1477525632
Michigan Other 080B86010

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