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NPI Code Detail

MEDICARE: CHESAPEAKE SPINE AND PAIN LLC

MEDICARE: CHESAPEAKE SPINE AND PAIN LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207LP2900XPain Medicine (Anesthesiology) Physician

General Provider Information

NPI Number : 1497431803
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHESAPEAKE SPINE AND PAIN LLC
Provider Business Mailing Address
First Line : 7821 TILGHMAN ST
Second Line :
City : FULTON
State : MD
Zip : 20759-2580
Country : US
Telephone Number : 301-538-1226
Fax Number : 301-893-3481
Provider Business Practice Location Address
First Line : 110 HOSPITAL RD STE 211
Second Line :
City : PRINCE FREDERICK
State : MD
Zip : 20678-4040
Country : US
Telephone Number : 410-656-2869
Fax Number : 301-893-3481
Authorized Official
Title or Position : CEO
Name : ANVER SALEEM KHAN
Credential : DO
Telephone Number : 301-538-1226
Provider Enumeration Date : 06/22/2023
Last Update Date : 07/06/2023

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Directions to “CHESAPEAKE SPINE AND PAIN LLC ” Practice Location

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