Healthcare Provider Details
I. General information
NPI: 1740012335
Provider Name (Legal Business Name): CHESAPEAKE BAY ORTHOPEDICS, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/14/2024
Last Update Date: 08/14/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1340 MIDDLEFORD RD STE 403
SEAFORD DE
19973-3665
US
IV. Provider business mailing address
828 AIRPAX RD STE 700
CAMBRIDGE MD
21613-6401
US
V. Phone/Fax
- Phone: 410-901-8370
- Fax: 410-901-8373
- Phone: 410-901-8370
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHAEL
JAMES
WARD
Title or Position: OWNER
Credential:
Phone: 410-901-8370