Provider Demographics
NPI:1285721522
Name:CHESAPEAKE NEUROLOGY & SPINE AT ST. MARY'S
Entity type:Organization
Organization Name:CHESAPEAKE NEUROLOGY & SPINE AT ST. MARY'S
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLIENT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:ASHBURN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-828-8100
Mailing Address - Street 1:8725 LOCH RAVEN BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-2227
Mailing Address - Country:US
Mailing Address - Phone:410-828-8100
Mailing Address - Fax:410-882-3310
Practice Address - Street 1:37767 MARKET DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE HALL
Practice Address - State:MD
Practice Address - Zip Code:20622-3188
Practice Address - Country:US
Practice Address - Phone:410-828-8100
Practice Address - Fax:410-882-3310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty