Provider Demographics
NPI:1508559154
Name:BAISDEN, GRACE C (MD)
Entity Type:Individual
Prefix:DR
First Name:GRACE
Middle Name:C
Last Name:BAISDEN
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 1:12815 PRICES DISTILLERY RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20871-9668
Mailing Address - Country:US
Mailing Address - Phone:240-750-5282
Mailing Address - Fax:
Practice Address - Street 1:8901 ROCKVILLE PIKE BETHESDA MD 20889
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-0001
Practice Address - Country:US
Practice Address - Phone:240-750-5282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-31
Last Update Date:2023-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider