Provider Demographics
NPI:1033264270
Name:DAVIS, MOLLIE M (MD)
Entity type:Individual
Prefix:
First Name:MOLLIE
Middle Name:M
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:31 ROBINSON RD
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-2841
Mailing Address - Country:US
Mailing Address - Phone:410-544-5900
Mailing Address - Fax:410-556-8614
Practice Address - Street 1:31 ROBINSON RD
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-2841
Practice Address - Country:US
Practice Address - Phone:410-544-5900
Practice Address - Fax:410-556-8614
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2024-08-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0065490207R00000X, 208000000X
MDD654902083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine