# BAYSHORE MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619625241
- **Authorized official:** DR. RYAN SHAKLEY DC (OWNER)
- **Authorized official phone:** (410) 251-8572

## Contact information

- **Practice address:** 185 HARRY S TRUMAN PKWY STE 100, ANNAPOLIS, MD 21401-7580
- **Practice address phone:** (410) 263-4171
- **Practice address fax:** (410) 263-4275
- **Mailing address:** 185 HARRY S TRUMAN PKWY STE 100, ANNAPOLIS, MD 21401-7580
- **Mailing address phone:** (410) 263-4171
- **Mailing address fax:** (410) 263-4275

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/14/2022
- **Last updated:** 03/06/2024