Organization
ORTHOPAEDIC AND SPORTS MEDICINE CENTER LLC
Active
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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