# BRIAN C. DE MUTH M.D., PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Chesapeake Sports & Orthopaedics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235284415
- **Authorized official:** DR. BRIAN CHARLES DE MUTH M.D. (PHYSICIAN)
- **Authorized official phone:** (410) 939-3400

## Contact information

- **Practice address:** 251 LEWIS LN, SUITE103, HAVRE DE GRACE, MD 21078-3751
- **Practice address phone:** (410) 939-3400
- **Practice address fax:** (410) 939-6400
- **Mailing address:** 251 LEWIS LN, SUITE 103, HAVRE DE GRACE, MD 21078-3751
- **Mailing address phone:** (410) 939-3400
- **Mailing address fax:** (410) 939-6400

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | D50790 | MD | Yes |

## Other

- **Enumeration date:** 01/25/2007
- **Last updated:** 05/21/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 522110201 | — | MD |