Provider Demographics
NPI:1013323799
Name:CHESAPEAKE RADIOLOGY OF BEL AIR
Entity Type:Organization
Organization Name:CHESAPEAKE RADIOLOGY OF BEL AIR
Other - Org Name:CHESAPEAKE RADIOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:L
Authorized Official - Last Name:ADZIMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-420-9800
Mailing Address - Street 1:2108 EMMORTON RD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-6800
Mailing Address - Country:US
Mailing Address - Phone:410-420-9800
Mailing Address - Fax:410-420-9975
Practice Address - Street 1:2108 EMMORTON RD
Practice Address - Street 2:SUITE 8
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-6800
Practice Address - Country:US
Practice Address - Phone:410-420-9800
Practice Address - Fax:410-420-9975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-02
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology