Provider Demographics
NPI:1497804769
Name:MCCATTY, SOYINI AYANNA (MD)
Entity Type:Individual
Prefix:
First Name:SOYINI
Middle Name:AYANNA
Last Name:MCCATTY
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 1:5000 COX RD
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-9263
Mailing Address - Country:US
Mailing Address - Phone:804-968-5700
Mailing Address - Fax:
Practice Address - Street 1:2855 CRAIN HWY
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20601-2807
Practice Address - Country:US
Practice Address - Phone:240-427-1926
Practice Address - Fax:240-427-1927
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0080028207Q00000X
FLME102487208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0003528-00Medicaid
MD444137YWV2Medicare PIN
MD443982ZDDBMedicare PIN
MD443982YVZMedicare PIN
FLBE504ZMedicare PIN
FLBE504YMedicare PIN