Provider Demographics
NPI:1508965930
Name:CHICO, ANTHONY ALOYSIUS III (DO)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:ALOYSIUS
Last Name:CHICO
Suffix:III
Gender:M
Credentials:DO
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Mailing Address - Street 1:6535 N CHARLES ST
Mailing Address - Street 2:STE 300
Mailing Address - City:BALTO
Mailing Address - State:MD
Mailing Address - Zip Code:21204
Mailing Address - Country:US
Mailing Address - Phone:410-938-5252
Mailing Address - Fax:410-938-5250
Practice Address - Street 1:7600 OSLER DRIVE
Practice Address - Street 2:STE 402
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204
Practice Address - Country:US
Practice Address - Phone:410-828-0103
Practice Address - Fax:410-828-0102
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MDH00596342084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDM891Medicare ID - Type Unspecified
I45905Medicare UPIN