Healthcare Provider Details

I. General information

NPI: 1215215678
Provider Name (Legal Business Name): EMILY CHA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: EMILY TAEKYUNG CHA MD

II. Dates (important events)

Enumeration Date: 08/02/2011
Last Update Date: 04/13/2023
Certification Date: 04/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13950 BRANDYWINE RD STE 225
BRANDYWINE MD
20613-5815
US

IV. Provider business mailing address

13950 BRANDYWINE RD STE 225
BRANDYWINE MD
20613-5815
US

V. Phone/Fax

Practice location:
  • Phone: 301-856-1682
  • Fax:
Mailing address:
  • Phone: 301-856-1682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number01082693A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number57139
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberBP10056953
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number01082693A
License Number StateIN
# 5
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number11016337A
License Number StateIN
# 6
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberD96263
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: