Organization
CHESAPEAKE UROLOGY ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANFORD JAY SIEGEL MD (PRESIDENT)
(410) 581-1600
Entity
Organization
Contact information
Practice address
12435 PARK POTOMAC AVE STE 410, POTOMAC, MD 20854-7037
(866) 953-3111
Mailing address
10200 GRAND CENTRAL AVE STE 220, OWINGS MILLS, MD 21117-4366
(443) 471-5839
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
276600155
—
MD
Enumeration date
11/19/2024
Last updated
03/08/2025
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