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NPI Code Detail

MEDICARE: SHANITA CHASE MD

MEDICARE: SHANITA CHASE MD
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
1207Q00000XFamily Medicine PhysicianD0063064MD

General Provider Information

NPI Number : 1487650891
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANITA CHASE MD
Provider Business Mailing Address
First Line : 1701 TWIN SPRINGS RD
Second Line :
City : HALETHORPE
State : MD
Zip : 21227-3553
Country : US
Telephone Number : 410-737-5000
Fax Number :
Provider Business Practice Location Address
First Line : 1701 TWIN SPRINGS RD
Second Line :
City : HALETHORPE
State : MD
Zip : 21227-3553
Country : US
Telephone Number : 410-737-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 06/25/2021

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Directions to “ SHANITA CHASE MD” Practice Location

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