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General NPI Number Information
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NPI Number | 1134211667
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Entity Type | Organization
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Legal Business Name | CHESAPEAKE RADIOLOGY LLC
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 04/04/2013
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Provider Practice Location Address
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Address Line | 602 S ATWOOD RD SUITE 102
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City | BEL AIR
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State | MD
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Zip | 21014-4172
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Country | US
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Telephone | 410-420-9980
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Fax | 410-420-9975
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Provider Business Mailing Address
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Address Line | 602 S ATWOOD RD SUITE102
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City | BEL AIR
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State | MD
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Zip | 21014-4172
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Country | US
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Telephone | 410-420-9980
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Fax | 410-420-9975
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | MR. PHILIP ADZIMA
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Credential |
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Telephone | 410-420-9980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 25-0445
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License Number State | MD
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