Provider Demographics
NPI:1396372173
Name:DEWBERRY, CHELSEA SMITH (MD)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:SMITH
Last Name:DEWBERRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6501 BALTIMORE NATIONAL PIKE STE D
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-3923
Mailing Address - Country:US
Mailing Address - Phone:667-234-2100
Mailing Address - Fax:410-744-5117
Practice Address - Street 1:6501 BALTIMORE NATIONAL PIKE STE D
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-3923
Practice Address - Country:US
Practice Address - Phone:667-234-2100
Practice Address - Fax:410-744-5117
Is Sole Proprietor?:No
Enumeration Date:2020-03-24
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD96210207R00000X
GA12152207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine