MEDICARE: CHESAPEAKE PODIATRY GROUP, P.A.

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	213E00000X	Podiatrist	00898	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	492776	OTHER		NCPPO
2	116079	OTHER		KAISER
3	2700091	OTHER		UNITED HEALTHCARE
4	4121973	OTHER		AETNA PPO
5	KY26	OTHER	MD	CAREFIRST BS
6	30463	OTHER		MAMSI
7	455055	OTHER		AETNA HMO
8	1243564001	OTHER		CIGNA
9	174130	OTHER		COVENTRY
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	90209000000	OTHER		PREFERRED HEALTH
12	E351	OTHER	DC	CAREFIRST BS

General Provider Information

NPI Number	:	1750388112
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHESAPEAKE PODIATRY GROUP, P.A.

Provider Business Mailing Address
First Line	:	910 WASHINGTON RD STE D
Second Line	:
City	:	WESTMINSTER
State	:	MD
Zip	:	21157-5845
Country	:	US
Telephone Number	:	410-876-8637
Fax Number	:	410-857-5273

Provider Business Practice Location Address
First Line	:	910 WASHINGTON RD STE D
Second Line	:
City	:	WESTMINSTER
State	:	MD
Zip	:	21157-5845
Country	:	US
Telephone Number	:	410-876-8637
Fax Number	:	410-857-5273

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ERIC L DIAMOND
Credential	:	DPM
Telephone Number	:	410-876-8637

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	10/09/2019

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