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General NPI Number Information
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NPI Number | 1063732576
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Entity Type | Organization
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Legal Business Name | CHESAPEAKE NEUROSURGICAL SERVICES LLC
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Dates
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Enumeration Date | 06/07/2010
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Last Update Date | 04/01/2011
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Provider Practice Location Address
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Address Line | 505 DUTCHMANS LN BLDG A
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City | EASTON
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State | MD
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Zip | 21601-4302
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Country | US
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Telephone | 410-822-9117
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Fax | 410-820-0512
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Provider Business Mailing Address
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Address Line | 505 DUTCHMANS LN BLDG A
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City | EASTON
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State | MD
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Zip | 21601-4302
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Country | US
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Telephone | 410-822-9117
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Fax | 410-820-0512
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Authorized Official
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Title or Position | INTERIM PRESIDENT/CEO
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Name | GERALD M WALSH
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Credential |
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Telephone | 410-822-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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