Healthcare Provider Details
I. General information
NPI: 1497027957
Provider Name (Legal Business Name): EDWIN C CHAPMAN MD PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/30/2012
Last Update Date: 01/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1647 BENNING RD NE 200
WASHINGTON DC
20002-4569
US
IV. Provider business mailing address
1647 BENNING RD NE 200
WASHINGTON DC
20002-4569
US
V. Phone/Fax
- Phone: 202-396-8550
- Fax: 202-388-4461
- Phone: 202-396-8550
- Fax: 202-388-4461
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 10544 |
| License Number State | DC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RA0401X |
| Taxonomy | Addiction Medicine (Internal Medicine) Physician |
| License Number | 10544 |
| License Number State | DC |
VIII. Authorized Official
Name: DR.
EDWIN
CHARLES
CHAPMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 202-396-8550