# CHESAPEAKE LASER & SKIN CARE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164751251
- **Authorized official:** MR. EDGAR FREDERICK PEITHMAN JR. PA C (OWNER)
- **Authorized official phone:** (410) 530-0331

## Contact information

- **Practice address:** 127 TANNERS POINT DR, STEVENSVILLE, MD 21666-3701
- **Practice address phone:** (407) 328-0825
- **Practice address fax:** (407) 322-5478
- **Mailing address:** 127 TANNERS POINT DR, STEVENSVILLE, MD 21666-3701
- **Mailing address phone:** (407) 328-0825
- **Mailing address fax:** (407) 322-5478

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AS0400X | Surgical Physician Assistant | C0001172 | MD | Yes |

## Other

- **Enumeration date:** 12/18/2009
- **Last updated:** 12/18/2009