Chesapeake Wellness Center
Organization Active NPI Addiction Medicine (Family Medicine) Physician · Cecilton, MD
NPI 1760093009 · NPPES record last updated Aug 20, 2020
Key facts
- NPI
- 1760093009
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Addiction Medicine (Family Medicine) Physician 207QA0401X
- Legal business name
- CHESAPEAKE WELLNESS CENTER
- Practice address
- 251 S Bohemia Ave
Cecilton, MD 21913-1010 - Phone
- (410) 275-8156
- NPI assigned
- Aug 11, 2020
- Organization subpart
- No
Authorized official
- Name
- Jane E Hyskell
- Title
- Billing Agent
- Phone
- (814) 938-8263
Corporate family (same tax ID) 5
National Provider Directory
- Tax ID family
- Chesapeake Wellness Center
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Family Medicine) Physician |
207QA0401X | Yes |
Addresses
Primary practice location
251 S Bohemia Ave
Cecilton, MD 21913-1010
Mailing address
PO Box 669
Cecilton, MD 21913-0669
Phone (410) 275-8156
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 456312300 | Medicaid | MD | |
| 627009300 | Medicaid | MD | |
| 205409400 | Medicaid | MD |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | pkatz@PMKD-MD.direct.office.nextgen.com | Direct |
Other providers in Cecilton, MD
- Cecilton Volunteer Fire Co Inc
- Chesapeake Wellness Center
- Joseph David Cohn Jr.
- Harmony Happiness and Hope LLC
- Paul M Katz
- Wallace Obenshain
- Paul Katz, D.O.
All providers in Cecilton, MD · Addiction Medicine (Family Medicine) Physician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 20, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.