Provider Demographics
NPI:1831112283
Name:AMEREE, BARYALAY (MD)
Entity Type:Individual
Prefix:DR
First Name:BARYALAY
Middle Name:
Last Name:AMEREE
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 1:2300 OPITZ BLVD STE G-209
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-3311
Mailing Address - Country:US
Mailing Address - Phone:703-523-0611
Mailing Address - Fax:703-670-2089
Practice Address - Street 1:2300 OPITZ BLVD STE G-209
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3311
Practice Address - Country:US
Practice Address - Phone:703-523-0611
Practice Address - Fax:703-670-2089
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD060828L207R00000X, 208M00000X
VA0101230328208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS1559187OtherAMERICAN ADMIN GROUP
PA5660574OtherAETNA
PA591462OtherHIGHMARK BLUE SHIELD
MS00119439Medicaid
PA0016239240003Medicaid
PAG42953OtherHEALTHAMERICA
PA820480OtherFIRST PRIORITY HEALTH
PA0016239240003Medicaid
MS110001431Medicare ID - Type Unspecified
MS1559187OtherAMERICAN ADMIN GROUP
PAG42953OtherHEALTHAMERICA