Provider Demographics
NPI:1154710937
Name:BAYEVA, MARINA (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:MARINA
Middle Name:
Last Name:BAYEVA
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:MARYNA
Other - Middle Name:
Other - Last Name:BAYEVA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:25 MAIN STREET, PO BOX 962
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01262-0962
Mailing Address - Country:US
Mailing Address - Phone:413-931-5205
Mailing Address - Fax:413-298-4020
Practice Address - Street 1:25 MAIN STREET
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01262
Practice Address - Country:US
Practice Address - Phone:413-931-5205
Practice Address - Fax:412-298-4020
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-15
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2796472084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry