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General NPI Number Information
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NPI Number | 1649181249
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Entity Type | Individual
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Provider Name | MARISSA CHUCK PA
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Gender | Female
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Dates
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Enumeration Date | 09/14/2026
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Last Update Date | 09/14/2026
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Provider Practice Location Address
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Address Line | 7335 HANOVER PKWY STE B
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City | GREENBELT
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State | MD
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Zip | 20770-3623
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Country | US
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Telephone | 443-218-6154
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Fax |
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Provider Business Mailing Address
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Address Line | 8900 COLUMBIA 100 PKWY STE E
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City | COLUMBIA
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State | MD
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Zip | 21045-2336
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Country | US
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Telephone | 443-380-0060
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | MD
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