1558394643 NPI number — DR. ARTHUR DISINI CHUTUAPE M.D.

Table of content: DR. ARTHUR DISINI CHUTUAPE M.D. (NPI 1558394643)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558394643 NPI number — DR. ARTHUR DISINI CHUTUAPE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHUTUAPE
Provider First Name:
ARTHUR
Provider Middle Name:
DISINI
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHUTUAPE
Provider Other First Name:
ARTHUR
Provider Other Middle Name:
DOUGLAS
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1558394643
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/27/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7764 ARMISTEAD RD STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LORTON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22079-1918
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-339-3524
Provider Business Mailing Address Fax Number:
703-339-9157

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8988 LORTON STATION BLVD
Provider Second Line Business Practice Location Address:
#204
Provider Business Practice Location Address City Name:
LORTON
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22079-4733
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-339-3524
Provider Business Practice Location Address Fax Number:
703-339-9157
Provider Enumeration Date:
07/09/2006

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: 174400000X , with the licence number:  0101057686 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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