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General NPI Number Information
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NPI Number | 1699894857
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Entity Type | Organization
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Legal Business Name | CHESAPEAKE PEDIATRIC & ADOLESCENT ASSOCIATES, PA
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 09/16/2024
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Provider Practice Location Address
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Address Line | 106 MILFORD ST STE 201
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City | SALISBURY
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State | MD
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Zip | 21804-6959
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Country | US
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Telephone | 410-543-1616
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Fax | 410-543-8497
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Provider Business Mailing Address
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Address Line | 106 MILFORD ST STE 201
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City | SALISBURY
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State | MD
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Zip | 21804-6959
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Country | US
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Telephone | 410-543-1616
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Fax | 410-543-8497
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Authorized Official
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Title or Position | OPERATIONS COORDINATOR
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Name | KIM WATSON
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Credential |
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Telephone | 410-543-1616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number |
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License Number State | MD
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