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NPI Code Detail

MEDICARE: PROJECT CHESAPEAKE LLC

MEDICARE: PROJECT CHESAPEAKE LLC
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
11041C0700XClinical Social Worker17401MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588112221
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROJECT CHESAPEAKE LLC
Provider Business Mailing Address
First Line : 185 ADMIRAL COCHRANE DR STE 120
Second Line :
City : ANNAPOLIS
State : MD
Zip : 21401-7600
Country : US
Telephone Number : 443-440-5780
Fax Number :
Provider Business Practice Location Address
First Line : 69 SHERRY LN STE 2
Second Line :
City : PRINCE FREDERICK
State : MD
Zip : 20678-3231
Country : US
Telephone Number : 443-968-8331
Fax Number : 443-378-8538
Authorized Official
Title or Position : PARTNER
Name : JOSEPH ROGERS
Credential :
Telephone Number : 443-440-5780
Provider Enumeration Date : 09/12/2016
Last Update Date : 07/21/2022

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Directions to “PROJECT CHESAPEAKE LLC ” Practice Location

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