Chalmers Frazer

Individual provider Active NPI Clinical Social Worker · Ridgely, MD

NPI 1689146342 · NPPES record last updated Dec 19, 2018

Key facts

NPI
1689146342
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
3341 (MD)
Practice address
14299 Benedictine LN
Ridgely, MD 21660-1434
Phone
(410) 634-2112
Fax
(410) 634-2640
NPI assigned
Dec 19, 2018
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
3341MDMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 3341 MD Yes

Addresses

Primary practice location

14299 Benedictine LN
Ridgely, MD 21660-1434

Mailing address

14299 Benedictine LN
Ridgely, MD 21660-1434
Phone (410) 634-2112

Other providers in Ridgely, MD

All providers in Ridgely, MD · Clinical Social Worker in Maryland

Sources for this page

Verify at the official NPI Registry.