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1033264270

NPI Code Detail

MEDICARE: MOLLIE M DAVIS MD

MEDICARE: MOLLIE M DAVIS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	D0065490	MD
2	208000000X	Pediatrics Physician	D0065490	MD
3	2083X0100X	Occupational Medicine Physician	D65490	MD

General Provider Information

NPI Number	:	1033264270
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOLLIE M DAVIS MD

Provider Business Mailing Address
First Line	:	31 ROBINSON RD
Second Line	:
City	:	SEVERNA PARK
State	:	MD
Zip	:	21146-2841
Country	:	US
Telephone Number	:	410-544-5900
Fax Number	:	410-556-8614

Provider Business Practice Location Address
First Line	:	31 ROBINSON RD
Second Line	:
City	:	SEVERNA PARK
State	:	MD
Zip	:	21146-2841
Country	:	US
Telephone Number	:	410-544-5900
Fax Number	:	410-556-8614

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2007
Last Update Date	:	08/28/2024

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Directions to “ MOLLIE M DAVIS MD” Practice Location

Language	Start Address	Practice Location

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