Healthcare Provider Details

I. General information

NPI: 1720342991
Provider Name (Legal Business Name): MARCEL CHEGNUI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2012
Last Update Date: 08/12/2022
Certification Date: 08/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2509 PENNSYLVANIA AVE
BALTIMORE MD
21217-1740
US

IV. Provider business mailing address

2509 PENNSYLVANIA AVE
BALTIMORE MD
21217-1740
US

V. Phone/Fax

Practice location:
  • Phone: 410-225-2091
  • Fax: 410-669-8790
Mailing address:
  • Phone: 410-225-2091
  • Fax: 410-669-8790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number27010
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: