Provider Demographics
NPI:1982746384
Name:PRIDDY, EUGENIA (MD)
Entity Type:Individual
Prefix:DR
First Name:EUGENIA
Middle Name:
Last Name:PRIDDY
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 1:1221 TAYLOR ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-5617
Mailing Address - Country:US
Mailing Address - Phone:202-464-9200
Mailing Address - Fax:202-464-5740
Practice Address - Street 1:1221 TAYLOR ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-5617
Practice Address - Country:US
Practice Address - Phone:202-464-9200
Practice Address - Fax:202-464-5740
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD328192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC5231OtherHEALTHRIGHT(MEDICAID MCO)
DC23655OtherCHARTERED(MEDICIAD MCO)
DC296133OtherAMERIGROUP (DC MEDICAID
DC296133OtherAMERIGROUP (DC MEDICAID
DCI29577Medicare UPIN