Organization
ORTHOPAEDIC AND SPORTS MEDICINE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK CHAPUT (ADMINISTRATOR CEO)
(410) 268-8862
Entity
Organization
Contact information
Practice address
108 FORBES ST, ANNAPOLIS, MD 21401-1502
(410) 268-8862
(410) 280-4701
Mailing address
108 FORBES ST, ANNAPOLIS, MD 21401-1502
(410) 268-8862
(410) 280-4701
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146000500
—
MD
Enumeration date
05/27/2005
Last updated
12/17/2007
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