Provider Demographics
NPI:1316912991
Name:COVINGTON, DAMIAN L (M D)
Entity type:Individual
Prefix:
First Name:DAMIAN
Middle Name:L
Last Name:COVINGTON
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 N 28TH ST
Mailing Address - Street 2:STE 300
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-5311
Mailing Address - Country:US
Mailing Address - Phone:804-225-7177
Mailing Address - Fax:804-225-7176
Practice Address - Street 1:11020 HULL STREET RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-3200
Practice Address - Country:US
Practice Address - Phone:804-744-6310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101227874207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAH40485Medicare UPIN
VA002748P95Medicare PIN