Provider Demographics
NPI:1285854026
Name:UPPER CHESAPEAKE EMERGENCY MEDICINE PHYSICIANS, LLC
Entity Type:Organization
Organization Name:UPPER CHESAPEAKE EMERGENCY MEDICINE PHYSICIANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:PIMENTEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:667-214-2062
Mailing Address - Street 1:PO BOX 412312
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-2312
Mailing Address - Country:US
Mailing Address - Phone:855-691-9890
Mailing Address - Fax:
Practice Address - Street 1:520 UPPER CHESAPEAKE DR
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4339
Practice Address - Country:US
Practice Address - Phone:240-529-1457
Practice Address - Fax:301-631-1002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD489PMedicare PIN