Provider Demographics
NPI:1346337060
Name:WILLIS, ASHLEY CHRISTINE (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:CHRISTINE
Last Name:WILLIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8186 LARK BROWN RD
Mailing Address - Street 2:STE 201
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6434
Mailing Address - Country:US
Mailing Address - Phone:410-730-3399
Mailing Address - Fax:443-478-4726
Practice Address - Street 1:5100 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-2772
Practice Address - Country:US
Practice Address - Phone:410-814-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0063773207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine