Provider Demographics
NPI:1538474937
Name:DAVIS, MARIA ISABELLA (RPH)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ISABELLA
Last Name:DAVIS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 FALLS RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-1813
Mailing Address - Country:US
Mailing Address - Phone:410-467-7004
Mailing Address - Fax:410-467-3725
Practice Address - Street 1:3700 FALLS RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21211-1813
Practice Address - Country:US
Practice Address - Phone:410-467-7004
Practice Address - Fax:410-467-3725
Is Sole Proprietor?:No
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12209183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist