1629139423 NPI number — MS. MICHELE CHAPMAN MA FAAA

Table of content: MS. MICHELE CHAPMAN MA FAAA (NPI 1629139423)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629139423 NPI number — MS. MICHELE CHAPMAN MA FAAA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHAPMAN
Provider First Name:
MICHELE
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MA FAAA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1629139423
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/20/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
111 ELWYN ROAD
Provider Second Line Business Mailing Address:
YAGO BUILDING SUITE B1
Provider Business Mailing Address City Name:
ELWYN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19063-4622
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-891-2188
Provider Business Mailing Address Fax Number:
610-891-7000

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
111 ELWYN ROAD
Provider Second Line Business Practice Location Address:
YAGO BUILDING SUITE B1
Provider Business Practice Location Address City Name:
ELWYN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19063-4622
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-891-2216
Provider Business Practice Location Address Fax Number:
610-891-7000
Provider Enumeration Date:
12/13/2006

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: 231H00000X , with the licence number:  AT000325L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 01650350 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0461606000 . This is a "BC HMO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1154157 . This is a "KEYSTONE MERCY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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