Basic Information
| Provider Information | |||||||||
| NPI: | 1437150042 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHAMBERLAIN | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | MARTIN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1111 BENFIELD BLVD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | MILLERSVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211083002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107295100 | ||||||||
| FaxNumber: | 4107295156 | ||||||||
| Practice Location | |||||||||
| Address1: | 125 SHOREWAY DR | ||||||||
| Address2: | SUITE 120 | ||||||||
| City: | QUEENSTOWN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 216581666 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4108274001 | ||||||||
| FaxNumber: | 4108274333 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2005 | ||||||||
| LastUpdateDate: | 12/05/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | D0037064 | MD | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 100059 | 01 | MD | AETNA CAPITATED BN | OTHER | 100064 | 01 | MD | AETNA CAPITATED KI | OTHER | 351089-12 | 01 | MD | CAREFIRST MD RENDERING KI | OTHER | 835422 | 01 | MD | MAMSI PRIMARY CARE BN | OTHER | 1406209 | 01 | MD | CIGNA PIN | OTHER | 013200 | 01 | MD | JHHC PROVIDER NUMBER | OTHER | 2114468 | 01 | MD | MAMSI SPECIALIST KI | OTHER | 4567843 | 01 | MD | AETNA FEE FOR SERVICE | OTHER | P11963 | 01 | MD | CAREFIRST MPOS | OTHER | 351089-01 | 01 | MD | CAREFIRST MD RENDERING BN | OTHER | 526171600 | 05 | MD | MEDICAID | 7605-0042 | 01 | MD | CAREFIRST BLUECHOICE | OTHER | 80083145 | 01 | MD | RR MEDICARE BN | OTHER | 235422 | 01 | MD | MAMSI SPECIALIST BN | OTHER | 80083132 | 01 | MD | RR MEDICARE KI | OTHER | 8114468 | 01 | MD | MAMSI PRIMARY CARE | OTHER |