Provider Demographics
NPI:1801815063
Name:CHESAPEAKE RADIOLOGISTS LTD
Entity Type:Organization
Organization Name:CHESAPEAKE RADIOLOGISTS LTD
Other - Org Name:CHESAPEAKE RADIOLOGIST LTD
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SRINESH
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLE
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:540-361-1000
Mailing Address - Street 1:PO BOX 844527
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02284-4527
Mailing Address - Country:US
Mailing Address - Phone:757-312-6124
Mailing Address - Fax:757-312-6195
Practice Address - Street 1:736 BATTLEFIELD BLVD N
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4941
Practice Address - Country:US
Practice Address - Phone:757-312-6124
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6740OtherRAILROAD MEDICARE
CA6740OtherRAILROAD MEDICARE
VAC00688Medicare PIN