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General NPI Number Information
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NPI Number | 1851150775
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Entity Type | Organization
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Legal Business Name | UPPER CHESAPEAKE SURGICAL ASSOCIATES, LLC
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Dates
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Enumeration Date | 03/14/2024
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Last Update Date | 03/14/2024
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Provider Practice Location Address
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Address Line | 360 E PULASKI HWY STE 2A
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City | ELKTON
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State | MD
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Zip | 21921-6595
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Country | US
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Telephone | 410-620-3348
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Fax | 410-620-3351
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Provider Business Mailing Address
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Address Line | 900 ELKRIDGE LANDING RD FL 2
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City | LINTHICUM
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State | MD
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Zip | 21090-2924
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Country | US
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Telephone | 443-462-5010
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MARCUS THOMAS AUGUSTUS PRIOLO
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Credential |
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Telephone | 443-643-3344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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