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General NPI Number Information
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NPI Number | 1194974360
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Entity Type | Organization
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Legal Business Name | CHESAPEAKE NEUROLOGY AND SPINE
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Dates
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Enumeration Date | 09/12/2008
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Last Update Date | 02/13/2024
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Provider Practice Location Address
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Address Line | 28105 THREE NOTCH RD # 1C
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City | MECHANICSVILLE
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State | MD
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Zip | 20659-3235
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Country | US
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Telephone | 301-290-1510
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Fax | 301-290-1574
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Provider Business Mailing Address
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Address Line | 28105 THREE NOTCH RD # 1C
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City | MECHANICSVILLE
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State | MD
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Zip | 20659-3235
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Country | US
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Telephone | 301-290-1510
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Fax | 301-290-1574
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Authorized Official
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Title or Position | OWNER/ MD
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Name | AHMED KAFAJI
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Credential | MD
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Telephone | 301-290-1510
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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 | D0060886
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License Number State | MD
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