Provider Demographics
NPI:1285609925
Name:PRIEST, SHANDA B (MD)
Entity type:Individual
Prefix:DR
First Name:SHANDA
Middle Name:B
Last Name:PRIEST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHANDA
Other - Middle Name:
Other - Last Name:BRAGG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1404 S MAIN CHAPEL WAY STE 104-1022
Mailing Address - Street 2:
Mailing Address - City:GAMBRILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21054-1857
Mailing Address - Country:US
Mailing Address - Phone:202-215-6267
Mailing Address - Fax:
Practice Address - Street 1:8450 DORSEY RUN RD
Practice Address - Street 2:
Practice Address - City:JESSUP
Practice Address - State:MD
Practice Address - Zip Code:20794-9486
Practice Address - Country:US
Practice Address - Phone:410-724-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD0358302084P0800X
MDD748762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry