Provider Demographics
NPI:1538472584
Name:CHESAPEAKE CARDIOVASCULAR SPECIALISTS PC
Entity Type:Organization
Organization Name:CHESAPEAKE CARDIOVASCULAR SPECIALISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KILICAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-980-2383
Mailing Address - Street 1:7501 SURRATTS RD
Mailing Address - Street 2:SUITE 208 A
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-3362
Mailing Address - Country:US
Mailing Address - Phone:703-980-2383
Mailing Address - Fax:301-302-0896
Practice Address - Street 1:7501 SURRATTS RD
Practice Address - Street 2:SUITE 208 A
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-3362
Practice Address - Country:US
Practice Address - Phone:703-980-2383
Practice Address - Fax:301-302-0896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-20
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD035654207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty