Provider Demographics
NPI:1285852830
Name:EDFORD O. CHAMBERS, M.D. LLC
Entity Type:Organization
Organization Name:EDFORD O. CHAMBERS, M.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:EDFORD
Authorized Official - Middle Name:O
Authorized Official - Last Name:CHAMBERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-475-1692
Mailing Address - Street 1:P.O. BOX 1630
Mailing Address - Street 2:
Mailing Address - City:LEONARDTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20650-1630
Mailing Address - Country:US
Mailing Address - Phone:301-475-1692
Mailing Address - Fax:301-997-0912
Practice Address - Street 1:22650 CEDAR LANE
Practice Address - Street 2:ST. MARY'S MEDICAL ARTS BLDG
Practice Address - City:LEONARDTOWN
Practice Address - State:MD
Practice Address - Zip Code:20650-1630
Practice Address - Country:US
Practice Address - Phone:301-475-1692
Practice Address - Fax:301-997-0912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0044310207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD8208OtherBCBS-FEDERAL
MDLU04OtherCAREFIRST BCBS
MD8208OtherBCBS-NAT'L CAPITAL AREA
MDF62692Medicare UPIN
MD8208OtherBCBS-NAT'L CAPITAL AREA