Provider Demographics
NPI:1619660461
Name:BRIGGS, SHAWN R
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:R
Last Name:BRIGGS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 MYSTIC AVE
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-3254
Mailing Address - Country:US
Mailing Address - Phone:240-305-1130
Mailing Address - Fax:
Practice Address - Street 1:1710 MYSTIC AVE
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-3254
Practice Address - Country:US
Practice Address - Phone:240-305-1130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-30
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator