Organization
CHESAPEAKE OPEN MRI L L C
Active
Parent organization
CHESAPEAKE OPEN MRI
Other names
Chesapeake Medical Imaging
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHESAPEAKE OPEN MRI
Authorized official
MARK D BAGANZ M.D. (PRESIDENT)
(410) 822-1888
Entity
Organization
Contact information
Practice address
401 PURDY ST, EASTON, MD 21601-4060
(410) 822-1888
Mailing address
122 DEFENSE HWY STE 102, ANNAPOLIS, MD 21401-7044
(302) 526-1604
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
408127700
—
MD
01
—
F855
BLUE SHIELD
DC
01
—
LX26CH
BLUE SHIELD
MD
Enumeration date
03/18/2008
Last updated
09/09/2024
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