Organization
CHESAPEAKE OPEN MRI
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) 571-0350
Entity
Organization
Contact information
Practice address
122 DEFENSE HWY, ANNAPOLIS, MD 21401-7069
(410) 571-0350
Mailing address
122 DEFENSE HWY, ANNAPOLIS, MD 21401-7069
(410) 571-0350
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
03/18/2008
Last updated
03/18/2008
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