Organization
ANTIETAM SURGEONS CHARLES R CHANEY MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES R CHANEY MD (PRESIDENT ANTIETAM SURGEONS)
(301) 791-4866
Entity
Organization
Contact information
Practice address
363 S CLEVELAND AVE, HAGERSTOWN, MD 21740-5747
(301) 791-4866
(301) 791-1297
Mailing address
363 S CLEVELAND AVE, HAGERSTOWN, MD 21740-5747
(301) 791-4866
(301) 791-1297
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
D0014398
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1388590
CIGNA
MD
01
—
213667
MDIPA
MD
01
—
K4820001
BLUECHOICE
MD
Enumeration date
08/22/2006
Last updated
10/19/2007
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