Provider Demographics
NPI:1821065079
Name:CHESAPEAKE ONCOLOGY HEMATOLOGY ASSOC
Entity Type:Organization
Organization Name:CHESAPEAKE ONCOLOGY HEMATOLOGY ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:K
Authorized Official - Last Name:MECH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-553-8115
Mailing Address - Street 1:305 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-5805
Mailing Address - Country:US
Mailing Address - Phone:410-761-9896
Mailing Address - Fax:410-761-2250
Practice Address - Street 1:305 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-5805
Practice Address - Country:US
Practice Address - Phone:410-761-9896
Practice Address - Fax:411-761-2250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-07
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0203XAmbulatory Health Care FacilitiesClinic/CenterOncology, Radiation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD210121100Medicaid
MD6067000001Medicare NSC
MD210121100Medicaid