1932151651 NPI number — REBEKAH MAXINE CHAPNICK MD

Table of content: REBEKAH MAXINE CHAPNICK MD (NPI 1932151651)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932151651 NPI number — REBEKAH MAXINE CHAPNICK MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHAPNICK
Provider First Name:
REBEKAH
Provider Middle Name:
MAXINE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1932151651
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/24/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
24701 EUCLID AVE
Provider Second Line Business Mailing Address:
THIRD FLOOR BILLING SERVICES
Provider Business Mailing Address City Name:
EUCLID
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44117-1714
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-383-5303
Provider Business Mailing Address Fax Number:
216-383-5309

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18599 LAKE SHORE BLVD
Provider Second Line Business Practice Location Address:
STE 200
Provider Business Practice Location Address City Name:
EUCLID
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44119-1093
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-383-5303
Provider Business Practice Location Address Fax Number:
216-383-5309
Provider Enumeration Date:
05/17/2006

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: 207R00000X , with the licence number:  35-085050 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 26513668 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com