Provider Demographics
NPI:1962087338
Name:MARYLAND PHYSICAL MEDICINE & REHABILITATION LLC
Entity type:Organization
Organization Name:MARYLAND PHYSICAL MEDICINE & REHABILITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ MEDICAL PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:240-821-2467
Mailing Address - Street 1:7004 EAGLE CT
Mailing Address - Street 2:
Mailing Address - City:NEW MARKET
Mailing Address - State:MD
Mailing Address - Zip Code:21774-6738
Mailing Address - Country:US
Mailing Address - Phone:240-821-2467
Mailing Address - Fax:
Practice Address - Street 1:1850 NORMANDIE DR
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17408-1534
Practice Address - Country:US
Practice Address - Phone:240-821-2467
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty