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Individual

RICHARD I CHASE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OWNER

Contact information

Practice address
1721 PENNSYLVANIA AVE, BALTIMORE, MD 21217-3119
(410) 523-2121
Mailing address
PO BOX 374, MONKTON, MD 21111-0374
(443) 522-9479
(443) 522-9725

Taxonomy

Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
00887
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
357668000
MD
01
T041
BLUE CROSS BLUE SHIELD
MD
Enumeration date
03/14/2007
Last updated
01/14/2009
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