Basic Information
| Provider Information | |||||||||
| NPI: | 1114198835 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CHESAPEAKE MEDICAL SOLUTIONS, PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 31516 WINTERPLACE PKWY STE 103 | ||||||||
| Address2: | |||||||||
| City: | SALISBURY | ||||||||
| State: | MD | ||||||||
| PostalCode: | 218042417 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103346351 | ||||||||
| FaxNumber: | 4103346352 | ||||||||
| Practice Location | |||||||||
| Address1: | 2425 N SALISBURY BLVD | ||||||||
| Address2: | |||||||||
| City: | SALISBURY | ||||||||
| State: | MD | ||||||||
| PostalCode: | 218012138 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8772224934 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2008 | ||||||||
| LastUpdateDate: | 01/17/2018 | ||||||||
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| AuthorizedOfficialLastName: | GIANELLE | ||||||||
| AuthorizedOfficialFirstName: | ANGELA | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | BUSINESS MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 4103346351 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QU0200X | 20235706 | MD | Y | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
ID Information
| ID | Type | State | Issuer | Description | DD9023 | 01 | MD | RAILROAD MEDICARE | OTHER | 408316400 | 05 | MD | MEDICAID | 313541 | 01 | MD | COVENTRY | OTHER | 2145659ML2 | 01 | MD | MAMSI | OTHER | 2145659ML2 | 01 | MD | OPTIMUM CHOICE | OTHER | 248783 | 01 | MD | ANTHEM | OTHER | 3780-0000 | 01 | MD | BLUE CHOICE | OTHER | 7603709 | 01 | MD | AETNA | OTHER | 11ZM | 01 | MD | BLUE CROSS BLUE SHIELD | OTHER | 2145659ML2 | 01 | MD | MDIPA | OTHER | 3780-0000 | 01 | MD | BLUE CROSS FEDERAL | OTHER |