Provider Demographics
NPI:1407267370
Name:CHESAPEAKE MEDICAL ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:CHESAPEAKE MEDICAL ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BASSI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-863-8860
Mailing Address - Street 1:925 HEATHERFIELD LN
Mailing Address - Street 2:
Mailing Address - City:MILLERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21108-1961
Mailing Address - Country:US
Mailing Address - Phone:410-863-8860
Mailing Address - Fax:410-766-7305
Practice Address - Street 1:325 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-5860
Practice Address - Country:US
Practice Address - Phone:410-863-8860
Practice Address - Fax:410-766-7305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-14
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty