1891734869 NPI number — NORTHERN CHESAPEAKE ANESTHESIA ASSOCIATES

Table of content: (NPI 1891734869)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891734869 NPI number — NORTHERN CHESAPEAKE ANESTHESIA ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTHERN CHESAPEAKE ANESTHESIA ASSOCIATES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
NORTHERN CHESAPEAKE ANESTHESIA ASSOCIATES
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891734869
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
260 GATEWAY DR STE 20A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BEL AIR
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21014-4283
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-420-7630
Provider Business Mailing Address Fax Number:
410-420-7911

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
500 UPPER CHESAPEAKE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BEL AIR
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21014-4324
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-420-7630
Provider Business Practice Location Address Fax Number:
410-420-7911
Provider Enumeration Date:
06/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LEVI
Authorized Official First Name:
MARC
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
410-420-7630

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0001 . This is a "CAREFIRST" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 64265601 . This is a "CAREFIRST" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 64265602 . This is a "CAREFIRST" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 64267902 . This is a "CAREFIRST" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 0002 . This is a "CAREFIRST" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 64265603 . This is a "CAREFIRST" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 64267901 . This is a "CAREFIRST" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 64267903 . This is a "CAREFIRST" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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