Individual
DR. LISA MICHELLE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, PA-C
Contact information
Practice address
3950 WHITE ROSE WAY, ELLICOTT CITY, MD 21042-5822
(443) 865-5342
Mailing address
3950 WHITE ROSE WAY, ELLICOTT CITY, MD 21042-5822
(443) 865-5342
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
C0002863
MD
363AM0700X
Medical Physician Assistant
Primary
C0002863
MD
Other
Enumeration date
01/06/2025
Last updated
01/06/2025
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