Provider Demographics
NPI:1477602183
Name:GRIGGS, WEI SHEN DAI (MD)
Entity Type:Individual
Prefix:DR
First Name:WEI SHEN
Middle Name:DAI
Last Name:GRIGGS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:WEI-SHEN
Other - Middle Name:
Other - Last Name:DAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2722 MERRILEE DR
Mailing Address - Street 2:SUITE 230
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4400
Mailing Address - Country:US
Mailing Address - Phone:703-698-4483
Mailing Address - Fax:703-573-0880
Practice Address - Street 1:2722 MERRILEE DR
Practice Address - Street 2:SUITE 230
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4400
Practice Address - Country:US
Practice Address - Phone:703-698-4483
Practice Address - Fax:703-573-0880
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012413762085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
265307OtherKAISER
VA0100OtherCAREFIRST BCBS
VAP00432966Medicare PIN
VADC4259Medicare PIN
265307OtherKAISER
VA014180F12Medicare PIN
VA0100OtherCAREFIRST BCBS