Provider Demographics
NPI:1891734869
Name:NORTHERN CHESAPEAKE ANESTHESIA ASSOCIATES
Entity Type:Organization
Organization Name:NORTHERN CHESAPEAKE ANESTHESIA ASSOCIATES
Other - Org Name:NORTHERN CHESAPEAKE ANESTHESIA ASSOCIATES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-420-7630
Mailing Address - Street 1:260 GATEWAY DR STE 20A
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4283
Mailing Address - Country:US
Mailing Address - Phone:410-420-7630
Mailing Address - Fax:410-420-7911
Practice Address - Street 1:500 UPPER CHESAPEAKE DR
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4324
Practice Address - Country:US
Practice Address - Phone:410-420-7630
Practice Address - Fax:410-420-7911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-05
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0001OtherCAREFIRST
MD64265601OtherCAREFIRST
MD64265602OtherCAREFIRST
MD64267902OtherCAREFIRST
MD0002OtherCAREFIRST
MD64265603OtherCAREFIRST
MD64267901OtherCAREFIRST
MD64267903OtherCAREFIRST
MD0002OtherCAREFIRST
MDCC1649Medicare PIN
MD64267901OtherCAREFIRST