# CHESAPEAKE ORTHOPAEDIC AND SPORTS MEDICINE CENTER PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Drs Courtney, Keats & Jaworski PA
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407920143
- **Authorized official:** MS. BEVERLY J GAZMEN CMPE (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (410) 768-5555

## Contact information

- **Practice address:** 200 HOSPITAL DRIVE, GLEN BURNIE, MD 21061
- **Practice address phone:** (410) 768-5555
- **Practice address fax:** (410) 768-5835
- **Mailing address:** 200 HOSPITAL DRIVE, GLEN BURNIE, MD 21061
- **Mailing address phone:** (410) 768-5555
- **Mailing address fax:** (410) 768-5835

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/17/2006
- **Last updated:** 08/16/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 912851400 | — | MD |