| Upper Chesapeake Health Ancillary Services | |
|
650 Mchenry Rd Ste 1300 Aberdeen MD 21001-2607 | |
| (443) 843-6600 | |
| Not Available |
| Full Name | Upper Chesapeake Health Ancillary Services |
|---|---|
| Speciality | Internal Medicine |
| Location | 650 Mchenry Rd Ste 1300, Aberdeen, Maryland |
| Authorized Official Name and Position | Marcus Thomas Augustus Priolo (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 4436433344 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Upper Chesapeake Health Ancillary Services 650 Mchenry Rd Ste 1300 Aberdeen MD 21001-2607 Ph: (443) 843-6600 | Upper Chesapeake Health Ancillary Services 650 Mchenry Rd Ste 1300 Aberdeen MD 21001-2607 Ph: (443) 843-6600 |
| NPI Number | 1821711425 |
|---|---|
| Provider Enumeration Date | 09/20/2022 |
| Last Update Date | 11/22/2023 |
| Medicare PECOS PAC ID | 1850531351 |
|---|---|
| Medicare Enrollment ID | O20130705000158 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821711425 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208600000X | Surgery | (* (Not Available)) | Secondary |
| Provider Name | Loren A Elchik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790326387 PECOS PAC ID: 3870927387 Enrollment ID: I20191216001902 |
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