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General NPI Number Information
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NPI Number | 1073784005
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Entity Type | Organization
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Legal Business Name | CHESAPEAKE OPEN MRI L L C
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Dates
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Enumeration Date | 03/18/2008
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 6602 CHURCH HILL RD STE 150
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City | CHESTERTOWN
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State | MD
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Zip | 21620-2316
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Country | US
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Telephone | 410-810-0032
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Fax |
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Provider Business Mailing Address
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Address Line | 122 DEFENSE HWY STE 102
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City | ANNAPOLIS
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State | MD
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Zip | 21401-7044
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Country | US
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Telephone | 302-526-1604
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARK D BAGANZ
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Credential | M.D.
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Telephone | 410-810-0032
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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