Provider Demographics
NPI:1831637131
Name:DAVENPORT, MARSHA GUILFORD (MD)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:GUILFORD
Last Name:DAVENPORT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARSHA
Other - Middle Name:OLIVIA
Other - Last Name:GUILFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4208 BROOKSIDE OAKS
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5167
Mailing Address - Country:US
Mailing Address - Phone:410-382-7531
Mailing Address - Fax:
Practice Address - Street 1:200 E 33RD ST
Practice Address - Street 2:SUITE 136
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-3322
Practice Address - Country:US
Practice Address - Phone:410-554-6489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00380042083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine