Provider Demographics
NPI:1881799351
Name:MASIA, SHAWN L (MD)
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:L
Last Name:MASIA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10420 LITTLE PATUXENT PKWY
Mailing Address - Street 2:SUITE 250
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3533
Mailing Address - Country:US
Mailing Address - Phone:410-740-2370
Mailing Address - Fax:410-740-1518
Practice Address - Street 1:7 WHITE OAK DR
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:NY
Practice Address - Zip Code:11050-4215
Practice Address - Country:US
Practice Address - Phone:410-740-2370
Practice Address - Fax:410-740-1518
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2016-04-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA909572084N0400X
NY224-152-12084N0400X
NMTM2013-08982084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA90957AMedicare PIN
I41313Medicare UPIN
NYA400051483Medicare PIN