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Individual

SAMUEL CHADO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
11300 ROCKVILLE PIKE STE 1202, ROCKVILLE, MD 20852-3040
(301) 896-0890
(301) 896-0968
Mailing address
2630 CAMERON WAY, FREDERICK, MD 21701-3049
(301) 896-0890
(301) 896-0968

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT002819
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OPT002819
GEORGIA MEDICAL LICENSE
GA
01
TA2581
MD OPTOMETRY LICENSE
MD
Enumeration date
06/26/2014
Last updated
07/11/2023
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