Provider Demographics
NPI:1881669687
Name:BUIVYS, DAINA (APRN)
Entity Type:Individual
Prefix:
First Name:DAINA
Middle Name:
Last Name:BUIVYS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5730 EXECUTIVE DR STE 230
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-1762
Mailing Address - Country:US
Mailing Address - Phone:410-402-2379
Mailing Address - Fax:
Practice Address - Street 1:711 MAIDEN CHOICE LN
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21228-3632
Practice Address - Country:US
Practice Address - Phone:410-247-5602
Practice Address - Fax:410-242-1756
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR084493364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
0030OtherBCBS-DC
MD221700700Medicaid
MD7689842OtherBCBS
8301205OtherEVERCARE
138CER-768984-02OtherCAREFIRST BCBS OF MD
MD960801000Medicaid
76898402OtherBCBS
0943ER-768984-04OtherCAREFIRST BCBS OF MD
0030OtherBCBS-DC
MDS81583Medicare UPIN
MD890001129Medicare PIN