Provider Demographics
NPI:1912231077
Name:UPPER CHESAPEAKE HEALTH
Entity Type:Organization
Organization Name:UPPER CHESAPEAKE HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN OF EMERGENCY DEPARTMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FERMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRUETO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-643-2905
Mailing Address - Street 1:500 UPPER CHESAPEAKE DR
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4324
Mailing Address - Country:US
Mailing Address - Phone:410-643-2905
Mailing Address - Fax:
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:410-643-2905
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-22
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0004035282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital