Provider Demographics
NPI:1861053977
Name:DAVIS, RODESHA ZAKIA
Entity type:Individual
Prefix:
First Name:RODESHA
Middle Name:ZAKIA
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10630 LITTLE PATUXENT PKWY
Mailing Address - Street 2:STE 329
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3204
Mailing Address - Country:US
Mailing Address - Phone:410-569-5969
Mailing Address - Fax:
Practice Address - Street 1:1035 EMMORTON RD
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-5469
Practice Address - Country:US
Practice Address - Phone:410-569-5969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-28
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS04017111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor