Basic Information
| Provider Information | |||||||||
| NPI: | 1497801419 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UPPER CHESAPEAKE MEDICAL SERVICES, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 520 UPPER CHESAPEAKE DR | ||||||||
| Address2: | #405 | ||||||||
| City: | BEL AIR | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210144339 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4436431500 | ||||||||
| FaxNumber: | 4436431505 | ||||||||
| Practice Location | |||||||||
| Address1: | 500 UPPER CHESAPEAKE DR | ||||||||
| Address2: | |||||||||
| City: | BEL AIR | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210144324 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4436431500 | ||||||||
| FaxNumber: | 4436431505 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/25/2007 | ||||||||
| LastUpdateDate: | 12/09/2021 | ||||||||
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| AuthorizedOfficialLastName: | PRIOLO | ||||||||
| AuthorizedOfficialFirstName: | MARCUS | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 4436433340 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 12/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | MD | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.