Provider Demographics
NPI:1073729737
Name:COMPREHENSIVE ASTHMA AND ALLERGY CENTER
Entity Type:Organization
Organization Name:COMPREHENSIVE ASTHMA AND ALLERGY CENTER
Other - Org Name:CHESAPEAKE ASTHMA AND ALLERGY CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:SCHIEKEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-902-9666
Mailing Address - Street 1:10085 RED RUN BLVD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-4836
Mailing Address - Country:US
Mailing Address - Phone:410-902-9666
Mailing Address - Fax:410-902-9065
Practice Address - Street 1:10085 RED RUN BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-4836
Practice Address - Country:US
Practice Address - Phone:410-902-9666
Practice Address - Fax:410-902-9065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0032060207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD02-0094OtherUHC
MD025960OtherPRIORITY PARTNERS
MD02-0096OtherUHC
MDE6570001OtherCAREFIRST BLUECHOICE
MD61665OtherCOVENTRY
MD025960OtherJHHC
MD1254232004OtherCIGNA
MD7785OtherBCBS
MD06177OtherAMERIGROUP
MD425066OtherMAMSI
MD02-0093OtherUHC
MD497050OtherNCPPO
MD225066OtherMAMSI
MD4136740OtherAETNA
MD02-00328OtherUHC
MD02-0096OtherUHC
MD1254232004OtherCIGNA
MDD72208Medicare UPIN