Provider Demographics
NPI:1639594633
Name:CHILDERS, MOLLY K (MD)
Entity Type:Individual
Prefix:DR
First Name:MOLLY
Middle Name:K
Last Name:CHILDERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:501 6TH ST S APT 922
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4630
Mailing Address - Country:US
Mailing Address - Phone:727-767-7322
Mailing Address - Fax:727-767-8612
Practice Address - Street 1:501 6TH ST S APT 922
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4630
Practice Address - Country:US
Practice Address - Phone:727-767-7322
Practice Address - Fax:727-767-8612
Is Sole Proprietor?:No
Enumeration Date:2014-02-27
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME149936208M00000X, 2080P0203X
VA0101259324208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No208000000XAllopathic & Osteopathic PhysiciansPediatrics