Provider Demographics
NPI:1780644104
Name:CHAPEL VIEW FAMILY CARE PC
Entity Type:Organization
Organization Name:CHAPEL VIEW FAMILY CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANSTINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-529-9311
Mailing Address - Street 1:9524 BELAIR RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-1508
Mailing Address - Country:US
Mailing Address - Phone:410-529-2781
Mailing Address - Fax:410-529-0085
Practice Address - Street 1:9524 BELAIR RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21236-1508
Practice Address - Country:US
Practice Address - Phone:410-529-2781
Practice Address - Fax:410-529-0085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-28
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0045568207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDKQ67CHOtherMEDICARE
F88952Medicare PIN