Provider Demographics
NPI:1124400254
Name:BAILEY, SHAYNA (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAYNA
Middle Name:
Last Name:BAILEY
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 1:4400 MASSACHUSETTS AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-8003
Mailing Address - Country:US
Mailing Address - Phone:202-885-3565
Mailing Address - Fax:
Practice Address - Street 1:4400 MASSACHUSETTS AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-8003
Practice Address - Country:US
Practice Address - Phone:202-885-3565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-25
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00966252084P0800X
MI43011083172084P0800X
DCMD2100023192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0101267569OtherVA MEDICAL LICENSE
MDD0096625OtherMD MEDICAL LICENSE
DCMD210002319OtherDC MEDICAL LICENSE