Provider Demographics
NPI:1568150829
Name:BELL, CHETARA MARIEA
Entity Type:Individual
Prefix:
First Name:CHETARA
Middle Name:MARIEA
Last Name:BELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6106 EDMONDSON AVE STE 101B
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-1830
Mailing Address - Country:US
Mailing Address - Phone:410-935-1548
Mailing Address - Fax:
Practice Address - Street 1:6106 EDMONDSON AVE STE 101B
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-1830
Practice Address - Country:US
Practice Address - Phone:410-935-1548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD230414041172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker