MEDICARE: DR. PAUL CHUPKA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208M00000X	Hospitalist Physician	0102201321	VA
2	207R00000X	Internal Medicine Physician	010221321	VA
3	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	0102201321	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104898691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL CHUPKA MD

Provider Business Mailing Address
First Line	:	PO BOX 2546
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23450-2546
Country	:	US
Telephone Number	:	757-340-3489
Fax Number	:	757-340-4278

Provider Business Practice Location Address
First Line	:	1060 FIRST COLONIAL RD
Second Line	:	SENTARA VIRGINIA BEACH GENERAL HOSPITAL
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-3002
Country	:	US
Telephone Number	:	757-340-3489
Fax Number	:	757-340-4278

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2006
Last Update Date	:	07/09/2013

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Directions to “ DR. PAUL CHUPKA MD” Practice Location

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