Individual
DR. MARK D BAGANZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
122 DEFENSE HWY, CHESAPEAKE MEDICAL IMAGING, ANNAPOLIS, MD 21401-7069
(410) 571-0350
Mailing address
122 DEFENSE HWY, CHESAPEAKE MEDICAL IMAGING, ANNAPOLIS, MD 21401-7069
(410) 571-0350
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
D44496
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
065421301
—
MD
01
—
61070201
BLUE SHIELD
MD
01
—
F8550011
GHI
DC
Enumeration date
12/21/2006
Last updated
11/02/2012
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