Healthcare Provider Details

I. General information

NPI: 1891734869
Provider Name (Legal Business Name): NORTHERN CHESAPEAKE ANESTHESIA ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 UPPER CHESAPEAKE DR
BEL AIR MD
21014-4324
US

IV. Provider business mailing address

260 GATEWAY DR STE 20A
BEL AIR MD
21014-4283
US

V. Phone/Fax

Practice location:
  • Phone: 410-420-7630
  • Fax: 410-420-7911
Mailing address:
  • Phone: 410-420-7630
  • Fax: 410-420-7911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARC LEVI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 410-420-7630