Provider Demographics
NPI:1154371532
Name:CHADO, STEVEN MICHAEL (OD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:MICHAEL
Last Name:CHADO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8210 SKIPWITH DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-9499
Mailing Address - Country:US
Mailing Address - Phone:301-695-7547
Mailing Address - Fax:
Practice Address - Street 1:17850 GARLAND GROH BLVD
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-1992
Practice Address - Country:US
Practice Address - Phone:301-714-1379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA 858152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
521RMedicare PIN
MD521RMedicare ID - Type Unspecified
U50017Medicare UPIN