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Individual

MARIE D CHATHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
6565 N CHARLES ST, SUITE 203, TOWSON, MD 21204-6800
(443) 849-2353
Mailing address
PO BOX 418953, BOSTON, MA 02241-8953

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
D0020907
MD
207RP1001X
Pulmonary Disease Physician
Primary
D0020907
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0007 E554
BLUE CHOICE
MD
01
290010122
RAILROAD MEDICARE
01
30645001 420A
BLUE SHIELD
MD
01
4800004
UNITEDHEALTHCARE MCO
01
542085
MAMSI
01
90530
UNITEDHEALTHCARE
Enumeration date
10/13/2006
Last updated
01/12/2012
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