Healthcare Provider Details

I. General information

NPI: 1588499198
Provider Name (Legal Business Name): SHANNON AUDREY STEINES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2024
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7342 WISCONSIN AVE APT 2105
BETHESDA MD
20814-4071
US

IV. Provider business mailing address

7342 WISCONSIN AVE APT 2105
BETHESDA MD
20814-4071
US

V. Phone/Fax

Practice location:
  • Phone: 847-313-9885
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number0116042732
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: