Provider Demographics
NPI:1831226299
Name:PRICE, MOLLY D (MD)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:D
Last Name:PRICE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:J
Other - Last Name:DAYMONT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:122 DEFENSE HWY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7069
Mailing Address - Country:US
Mailing Address - Phone:410-266-9694
Mailing Address - Fax:410-266-9695
Practice Address - Street 1:122 DEFENSE HWY
Practice Address - Street 2:SUITE 210
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7069
Practice Address - Country:US
Practice Address - Phone:410-266-9694
Practice Address - Fax:410-266-9695
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD690912084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
6197596OtherAETNA HMO
9966462OtherAETNA PPO
MD419412800Medicaid
85490003OtherBCBS DC
961053 01OtherBCBS MD
9966462OtherAETNA PPO