Healthcare Provider Details

I. General information

NPI: 1275038747
Provider Name (Legal Business Name): CHAO LONG AZAD MD MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2018
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 N CALVERT ST STE 200
BALTIMORE MD
21218-6505
US

IV. Provider business mailing address

2341 MADISON AVE
BALTIMORE MD
21217-0030
US

V. Phone/Fax

Practice location:
  • Phone: 410-235-5405
  • Fax:
Mailing address:
  • Phone: 304-688-8304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License NumberD0103631
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: