Provider Demographics
NPI:1225038466
Name:OSHRY, STACY Y (MD)
Entity Type:Individual
Prefix:DR
First Name:STACY
Middle Name:Y
Last Name:OSHRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5510 ALMA LN
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22151-4012
Mailing Address - Country:US
Mailing Address - Phone:703-642-5990
Mailing Address - Fax:703-916-0672
Practice Address - Street 1:5510 ALMA LN
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22151-4012
Practice Address - Country:US
Practice Address - Phone:703-642-5990
Practice Address - Fax:703-916-0672
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101054272207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1126279OtherAFFORDABLE FIRST HEALTH
VA257645OtherMDIPA/OPTIMUM CHOICE/MAMS
VA334791OtherANTHEM HEALTHKEEPERS
VA334791OtherTRIGON KEYAD
VA5923609OtherAHP MGD CHOICE
VA360387OtherONE HEALTH GREATWEST
VA505116OtherNCPPO
VA5819431Medicaid
VA0403502OtherUNITED HEALTH MID-ATLANTI
VA45560006OtherBCBS DC CAPCARE
VA5325453-024OtherCIGNA HMO
VA0402551OtherUNITED HEALTH VIRGINIA
VA2119852OtherAETNA/US HEALTHCARE
VA5325453-024OtherCIGNA HMO
VA334791OtherANTHEM HEALTHKEEPERS