Healthcare Provider Details

I. General information

NPI: 1679783914
Provider Name (Legal Business Name): DAVID CHRISTIAN CHAPMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4530 N 32ND ST STE 102
PHOENIX AZ
85018-3357
US

IV. Provider business mailing address

3119 E PUGET AVE
PHOENIX AZ
85028-5328
US

V. Phone/Fax

Practice location:
  • Phone: 602-493-1626
  • Fax:
Mailing address:
  • Phone: 602-493-1626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PS0010X
TaxonomySports Medicine (Emergency Medicine) Physician
License Number24720
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: