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General NPI Number Information
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NPI Number | 1750388112
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Entity Type | Organization
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Legal Business Name | CHESAPEAKE PODIATRY GROUP, P.A.
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Dates
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Enumeration Date | 06/30/2005
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Last Update Date | 10/09/2019
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Provider Practice Location Address
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Address Line | 910 WASHINGTON RD STE D
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City | WESTMINSTER
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State | MD
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Zip | 21157-5845
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Country | US
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Telephone | 410-876-8637
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Fax | 410-857-5273
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Provider Business Mailing Address
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Address Line | 910 WASHINGTON RD STE D
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City | WESTMINSTER
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State | MD
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Zip | 21157-5845
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Country | US
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Telephone | 410-876-8637
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Fax | 410-857-5273
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Authorized Official
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Title or Position | OWNER
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Name | DR. ERIC L DIAMOND
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Credential | DPM
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Telephone | 410-876-8637
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 00898
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License Number State | MD
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