Provider Demographics
NPI:1487016119
Name:THOMPSON, CHELSEA HAYES (MD)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:HAYES
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:LYNN
Other - Last Name:HAYES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6201 GREENLEIGH AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-2004
Mailing Address - Country:US
Mailing Address - Phone:410-933-5412
Mailing Address - Fax:410-367-2118
Practice Address - Street 1:137 MITCHELLS CHANCE RD STE 180
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:MD
Practice Address - Zip Code:21037-2793
Practice Address - Country:US
Practice Address - Phone:410-224-8220
Practice Address - Fax:410-367-2118
Is Sole Proprietor?:No
Enumeration Date:2016-03-22
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101262992207Q00000X, 208D00000X
MDD0097077207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice