Organization
CHESAPEAKE PEDIATRIC & ADOLESCENT ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM WATSON (OPERATIONS COORDINATOR)
(410) 543-1616
Entity
Organization
Contact information
Practice address
106 MILFORD ST STE 201, SALISBURY, MD 21804-6959
(410) 543-1616
(410) 543-8497
Mailing address
106 MILFORD ST STE 201, SALISBURY, MD 21804-6959
(410) 543-1616
(410) 543-8497
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
188017
AMERIGROUP COMMUNITY CARE
MD
01
—
213297
UNITED HEALTHCARE
MD
01
—
283952
COVENTRY HEALTHCARE
MD
01
—
430401200
MARYLAND PHYSICIANS CARE
MD
05
—
430401200
—
MD
05
—
430401201
—
MD
01
—
4560463
AETNA
MD
01
—
826426
PRIORITY PARTNERS
MD
01
—
G113
BLUE CROSS BLUE CHOICE
MD
01
—
G113-0000
CAREFIRST
MD
01
—
S758CH
BLUE CROSS BLUE SHIELD
MD
Enumeration date
03/28/2007
Last updated
09/16/2024
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