Organization
CHESAPEAKE MEDICAL IMAGING
Active
Other names
Chesapeake Open MRI
Organization subpart
No
Provider details
NPI number
Authorized official
MARK D BAGANZ M.D. (PRESIDENT)
(410) 571-0350
Entity
Organization
Contact information
Practice address
108 FORBES ST, ANNAPOLIS, MD 21401-1502
(410) 268-8862
Mailing address
108 FORBES ST, ANNAPOLIS, MD 21401-1502
(410) 268-8862
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F855
BLUE SHIELD
DC
01
—
LX26CH
BLUE SHIELD
MD
Enumeration date
04/08/2008
Last updated
04/08/2008
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