Healthcare Provider Details

I. General information

NPI: 1518269554
Provider Name (Legal Business Name): CHESAPEAKE CARDIOVASCULAR SPECIALISTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2010
Last Update Date: 07/29/2021
Certification Date: 07/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2448 HOLLY AVE STE 300
ANNAPOLIS MD
21401-3164
US

IV. Provider business mailing address

2448 HOLLY AVE STE 300
ANNAPOLIS MD
21401-3164
US

V. Phone/Fax

Practice location:
  • Phone: 443-221-7812
  • Fax: 866-257-6009
Mailing address:
  • Phone: 443-221-7812
  • Fax: 866-257-6009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberD0057994
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberD0057994
License Number StateMD

VIII. Authorized Official

Name: SVEN INGO ENDER
Title or Position: OWNER
Credential: M.D.
Phone: 443-221-7812