Provider Demographics
NPI:1386127421
Name:CHESAPEAKE EYE CARE & LASER CENTER
Entity type:Organization
Organization Name:CHESAPEAKE EYE CARE & LASER CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-571-7998
Mailing Address - Street 1:800 PRINCE FREDERICK BLVD
Mailing Address - Street 2:
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-3145
Mailing Address - Country:US
Mailing Address - Phone:141-053-5227
Mailing Address - Fax:
Practice Address - Street 1:800 PRINCE FREDERICK BLVD
Practice Address - Street 2:
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-3145
Practice Address - Country:US
Practice Address - Phone:410-535-2270
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-14
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty