Provider Demographics
NPI:1093984163
Name:CHIMAX MEDICAL CENTER, LLC
Entity Type:Organization
Organization Name:CHIMAX MEDICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHIENYENWA
Authorized Official - Middle Name:EKE
Authorized Official - Last Name:NWACHINEMERE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-686-3931
Mailing Address - Street 1:1232 RACE RD STE 401
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-2386
Mailing Address - Country:US
Mailing Address - Phone:410-686-3931
Mailing Address - Fax:410-881-4572
Practice Address - Street 1:1232 RACE RD STE 401
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:MD
Practice Address - Zip Code:21237-2386
Practice Address - Country:US
Practice Address - Phone:410-686-3931
Practice Address - Fax:410-881-4572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-22
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0063176261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care