Provider Demographics
NPI:1518269554
Name:CHESAPEAKE CARDIOVASCULAR SPECIALISTS PC
Entity Type:Organization
Organization Name:CHESAPEAKE CARDIOVASCULAR SPECIALISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SVEN INGO
Authorized Official - Middle Name:
Authorized Official - Last Name:ENDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-221-7812
Mailing Address - Street 1:2448 HOLLY AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3164
Mailing Address - Country:US
Mailing Address - Phone:443-221-7812
Mailing Address - Fax:866-257-6009
Practice Address - Street 1:2448 HOLLY AVE STE 300
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3164
Practice Address - Country:US
Practice Address - Phone:443-221-7812
Practice Address - Fax:866-257-6009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-24
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0057994207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Multi-Specialty