MEDICARE: CHESAPEAKE NEUROLOGY AND SPINE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	D0060886	MD

General Provider Information

NPI Number	:	1194974360
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHESAPEAKE NEUROLOGY AND SPINE

Provider Business Mailing Address
First Line	:	28105 THREE NOTCH RD # 1C
Second Line	:
City	:	MECHANICSVILLE
State	:	MD
Zip	:	20659-3235
Country	:	US
Telephone Number	:	301-290-1510
Fax Number	:	301-290-1574

Provider Business Practice Location Address
First Line	:	28105 THREE NOTCH RD # 1C
Second Line	:
City	:	MECHANICSVILLE
State	:	MD
Zip	:	20659-3235
Country	:	US
Telephone Number	:	301-290-1510
Fax Number	:	301-290-1574

Authorized Official
Title or Position	:	OWNER/ MD
Name	:	AHMED KAFAJI
Credential	:	MD
Telephone Number	:	301-290-1510

Provider Enumeration Date	:	09/12/2008
Last Update Date	:	02/13/2024

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