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Organization
CHESAPEAKE PAIN CENTER, LLC
Active
Organization
CHESAPEAKE PAIN CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENJAMIN LEE M.D. (OWNER)
(443) 484-2828
Entity
Organization
Contact information
Practice address
2012 SOUTH TOLLGATE ROAD, SUITE 102, BEL AIR, MD 21015-5901
(443) 484-2828
(443) 484-2831
Mailing address
PO BOX 404, BEL AIR, MD 21014-0404
(443) 484-2828
(443) 484-2831
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
W11478880
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003003100
—
MD
01
—
10229730
AMERIGROUP
MD
01
—
109766
JOHNS HOPKINS HEALTH CARE
MD
01
—
220CCH
CAREFIRST BCBS
MD
01
—
541744325
COVENTRY
MD
01
—
5571764
AETNA
MD
01
—
K8170001
CAREFIRST BCBS
DC
Enumeration date
11/19/2008
Last updated
08/27/2010
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