Organization
CHESAPEAKE WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANE E HYSKELL (BILLING AGENT)
(814) 938-8263
Entity
Organization
Contact information
Practice address
251 S BOHEMIA AVE, CECILTON, MD 21913-1010
(410) 275-8156
Mailing address
PO BOX 669, CECILTON, MD 21913-0669
(410) 275-8156
(877) 433-6830
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205409400
—
MD
05
—
456312300
—
MD
05
—
627009300
—
MD
Enumeration date
08/11/2020
Last updated
08/20/2020
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