DR. CHUCKIA NICOLE BROWN-TISDALE (NPI# 1306836804) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306836804 |
| Entity Type | Individual |
| Full Name | DR. CHUCKIA NICOLE BROWN-TISDALE |
| Credential | M.D. |
| Practice Address |
11110 Medical Campus Rd Ste 143 Hagerstown MD 21742-6755 |
| Mailing Address |
11116 Medical Campus Rd Hagerstown MD 21742-6710 |
| Practice Telephone | 3017144175 |
| Practice Fax Number | 3017144183 |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2020-01-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | D0063718 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 409370400 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 11110 Medical Campus Rd, Suite 243, Hagerstown, MD 217426700 | 3016654600 | 3016654601 |
| Street Address |
11110 MEDICAL CAMPUS RD STE 143 |
| City | HAGERSTOWN |
| State | MD |
| Zip Code | 21742-6755 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972538841 | Samuel Chan | Internal Medicine | 11110 Medical Campus Rd Ste 143, Hagerstown, MD 21742-6755 | 2006-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154950251 | Caleb Lougheed | Student in an Organized Health Care Education/Training Program | Meritus Family Medicine Residency Program, 11110 Medical Campus Road, Suite 200, Hagerstown, MD 21742 | 2020-04-02 |
| 1770054900 | Katherine E Spann | Physician Assistant | Meritus Medical Center, 11116 Medical Campus Road, Hagerstown, MD 21742 | 2018-12-16 |
| 1760988950 | Kelli Jones | Nurse Anesthetist, Certified Registered | 11116 Medical Center, Hagerstown, MD 21742 | 2018-04-05 |
| 1740706324 | Michael E. Anderson, Dds, PC | Dentist | 18709 Crestwood Drive, Hagerstown, MD 21742 | 2017-08-16 |
| 1407387384 | Cynthia Brendle | Physical Therapy Assistant | 19800 Tranquility Circle, Robinwood Campus, Hagerstown, MD 21742 | 2017-03-23 |
| 1326411877 | Structural Elements, LLC | Acupuncturist | 13214 Fountainhead Plaza, Hagerstown, MD 21742 | 2015-11-05 |
| 1386057396 | Ma Pamela Borden | Occupational Therapist | 506 Lynnehaven Drive, Apartment G, Hagerstown, MD 21742 | 2014-06-06 |
| 1275971251 | Arti Babubhai Patel | Denturist | 13133 Gentry Drive, Hagerstown, MD 21742 | 2013-06-12 |
| 1063859551 | Premise Health of Maryland Medical P C | Clinic/Center | 13403 Volvo Way, Medical Suite, Hagerstown, MD 21742 | 2013-05-24 |
| 1386938363 | Rocky Mountain Holdings LLC | Ambulance | 18539 Henson Blvd, Hagerstown, MD 21742 | 2011-06-07 |
| Find all providers in zip 21742 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760090294 | Outreach Recovery II, LLC | Internal Medicine | 339 E Antietam St Ste 4, Hagerstown, MD 21740-5767 | 2020-07-21 |
| 1306406590 | Horizon Health Care Management Group LLC | Internal Medicine | 19509 Windsor Cir, Suite B, Hagerstown, MD 21742-2642 | 2019-06-19 |
| 1659667335 | Darnika Joy Rhodes | Internal Medicine | 13424 Pennsylvania Ave Ste 205, Hagerstown, MD 21742-2686 | 2011-06-22 |
| 1912159104 | Francis Howard Cost Jr. | Internal Medicine | 1100 North Potomac Avenue, Hagerstown, MD 21742-3439 | 2008-10-21 |
| 1013114834 | Dr Francisco L. Andrade | Internal Medicine | 350 Mill St, Hagerstown, MD 21740-6138 | 2007-06-27 |
| 1841384302 | Jaroslaw Kalka | Internal Medicine | 251 East Antietam St., Hagerstown, MD 21740 | 2006-10-02 |
| 1861584591 | Koduah Peprah | Internal Medicine | 324 E Antietam St Ste 306, Hagerstown, MD 21740-5768 | 2006-09-29 |
| 1952407710 | Tanvir Ahmad Pasha | Internal Medicine | 1122 Opal Ct, Hagerstown, MD 21740-5940 | 2006-09-16 |
| 1932145695 | Francisco L Andrade | Internal Medicine | 350 Mill Street, Hagerstown, MD 21740 | 2006-06-21 |
| 1366483323 | Farid Murshed | Internal Medicine | 1126 Opal Court, Hagerstown, MD 21740 | 2006-06-09 |
| Find all providers in HAGERSTOWN | ||||
| City | HAGERSTOWN |
| Zip Code | 21742 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.