Provider Demographics
NPI:1346375144
Name:CHIZMAR, KARA T (PT)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:T
Last Name:CHIZMAR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8114 SANDPIPER CIR
Mailing Address - Street 2:SUITE 213
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-4934
Mailing Address - Country:US
Mailing Address - Phone:410-933-3737
Mailing Address - Fax:410-933-3747
Practice Address - Street 1:8114 SANDPIPER CIR
Practice Address - Street 2:SUITE 213
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-4934
Practice Address - Country:US
Practice Address - Phone:410-933-3737
Practice Address - Fax:410-933-3747
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18089225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD54487005OtherBLUE CROSS BLUE SHIELD
MDDA2862 P00028683OtherRAILROAD MEDICARE
MDS9550003OtherBCBS FEDERAL
MD928L413EMedicare ID - Type Unspecified
MDP14979Medicare UPIN