MEDICARE: DR. ANDREA JENNIFER CHAMCZUK MD

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
1	207T00000X	Neurological Surgery Physician	D0102864	MD

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P01212534	OTHER	MS	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P01212534	OTHER	MS	RR MCR
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831475730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREA JENNIFER CHAMCZUK MD

Provider Business Mailing Address
First Line	:	12502 WILLOWBROOK RD
Second Line	:
City	:	CUMBERLAND
State	:	MD
Zip	:	21502-6491
Country	:	US
Telephone Number	:	240-964-8944
Fax Number	:	240-964-8942

Provider Business Practice Location Address
First Line	:	12502 WILLOWBROOK RD
Second Line	:
City	:	CUMBERLAND
State	:	MD
Zip	:	21502-6491
Country	:	US
Telephone Number	:	240-964-8944
Fax Number	:	240-964-8942

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2011
Last Update Date	:	05/11/2026

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Directions to “ DR. ANDREA JENNIFER CHAMCZUK MD” Practice Location

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