Provider Demographics
NPI:1922120898
Name:CHESTERTOWN PEDIATRICS
Entity Type:Organization
Organization Name:CHESTERTOWN PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDDY
Authorized Official - Middle Name:ORLANDO
Authorized Official - Last Name:ARAUJO-VIDAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD,FAAP
Authorized Official - Phone:410-778-2430
Mailing Address - Street 1:PO BOX 477
Mailing Address - Street 2:
Mailing Address - City:CHESTERTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21620-0477
Mailing Address - Country:US
Mailing Address - Phone:410-778-1420
Mailing Address - Fax:
Practice Address - Street 1:100 BROWN ST
Practice Address - Street 2:
Practice Address - City:CHESTERTOWN
Practice Address - State:MD
Practice Address - Zip Code:21620-1435
Practice Address - Country:US
Practice Address - Phone:410-778-1420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:2008-08-13
Deactivation Code:
Reactivation Date:2018-11-20
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty