| Doctor Name: | DR. BOLIVIA THERSE DAVIS |
| NPI Number: | 1073584413 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | D0043096 |
| Business Practice Address: | 21 Crossroads Dr Ste 100 Owings Mills, MD - 211175441 |
| Business Phone Number: | 4103568186 |
| Business Fax Number: | 4103564180 |
| Mailing Address: | 10373a Reisterstown Rd, OWINGS MILLS |
| State: | MD |
| Postal Code: | 211173617 |
| Phone Number: | 4103568186 |
| Fax Number: | 4103564180 |
| NPI Enumeration Date: | 02/01/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085N0700X |
| License Number: | D0043096 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | MD |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Neuroradiology |
| Taxonomy Definition: | A radiologist who diagnoses and treats diseases utilizing imaging procedures as they relate to the brain, spine and spinal cord, head, neck and organs of special sense in adults and children. |