1003692948 NPI number — CHELSEA ELISABETH FRISBIE MD, MS

Table of content: CHELSEA ELISABETH FRISBIE MD, MS (NPI 1003692948)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003692948 NPI number — CHELSEA ELISABETH FRISBIE MD, MS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FRISBIE
Provider First Name:
CHELSEA
Provider Middle Name:
ELISABETH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD, MS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BUTCHER
Provider Other First Name:
CHELSEA
Provider Other Middle Name:
ELISABETH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1003692948
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/06/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7319 HOPKINTON DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KALAMAZOO
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49009-4097
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
989-763-6668
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1214 RESEARCH BLVD STE 2000
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUMMELSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17036-9153
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
989-388-8883
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/06/2023

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208D00000X , with the licence number:  390200000X , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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