Healthcare Provider Details

I. General information

NPI: 1336561091
Provider Name (Legal Business Name): CHESAPEAKE CARDIOVASCULAR ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2014
Last Update Date: 03/28/2024
Certification Date: 03/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 N CALVERT ST JPB SUITE 500
BALTIMORE MD
21218-2867
US

IV. Provider business mailing address

3007 TILDEN ST NW STE 5N
WASHINGTON DC
20008-3030
US

V. Phone/Fax

Practice location:
  • Phone: 410-366-5600
  • Fax:
Mailing address:
  • Phone: 703-558-1400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE SCHNEIDER
Title or Position: VP
Credential:
Phone: 703-558-1403