Roger Wayne Davis
Individual provider Active NPI Driver · Montross, VA
NPI 1811409576 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1811409576
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- Practice address
- 539 Morris LN
Montross, VA 22520-2952 - Phone
- (804) 493-3214
- Fax
- (804) 493-3215
- NPI assigned
- Nov 2, 2017
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver |
172A00000X | VA | Yes |
Addresses
Primary practice location
539 Morris LN
Montross, VA 22520-2952
Mailing address
539 Morris LN
Montross, VA 22520-2952
Phone (804) 493-3214
Other providers in Montross, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.