Healthcare Provider Details

I. General information

NPI: 1023765625
Provider Name (Legal Business Name): CHESAPEAKE DIGESTIVE ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2022
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 RIDGELY AVE STE 201
ANNAPOLIS MD
21401-1083
US

IV. Provider business mailing address

621 RIDGELY AVE STE 201
ANNAPOLIS MD
21401-1083
US

V. Phone/Fax

Practice location:
  • Phone: 410-224-4887
  • Fax: 410-224-1428
Mailing address:
  • Phone: 410-224-4887
  • Fax: 410-224-1428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: ALAN OLIVER
Title or Position: CEO
Credential: CEO
Phone: 305-570-2495