Provider Demographics
NPI:1730281288
Name:DAVENPORT, EFFIE LEIGHTON (MD)
Entity Type:Individual
Prefix:DR
First Name:EFFIE
Middle Name:LEIGHTON
Last Name:DAVENPORT
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:PO BOX 1007
Mailing Address - Street 2:
Mailing Address - City:SAVAGE
Mailing Address - State:MD
Mailing Address - Zip Code:20763-1007
Mailing Address - Country:US
Mailing Address - Phone:301-490-3520
Mailing Address - Fax:
Practice Address - Street 1:5602 BALTIMORE NATIONAL PIKE
Practice Address - Street 2:SUITE 307
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21228-1411
Practice Address - Country:US
Practice Address - Phone:410-747-0454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD286312084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry