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General NPI Number Information
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NPI Number | 1497918650
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Entity Type | Organization
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Legal Business Name | CHESAPEAKE UROLOGY ASSOCIATES PA
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Dates
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Enumeration Date | 07/08/2008
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Last Update Date | 07/08/2008
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Provider Practice Location Address
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Address Line | 111 W HIGH ST STE 304
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City | ELKTON
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State | MD
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Zip | 21921-8617
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Country | US
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Telephone | 800-589-5954
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Fax | 410-398-3771
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Provider Business Mailing Address
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Address Line | PO BOX 630664
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City | BALTIMORE
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State | MD
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Zip | 21263-0664
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | DR. SANFORD SIEGEL
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Credential | MD
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Telephone | 410-581-1600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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