Healthcare Provider Details

I. General information

NPI: 1144214776
Provider Name (Legal Business Name): ANDREW WHYTE CHAPMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2005
Last Update Date: 02/04/2021
Certification Date: 02/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 GROSSMAN DR
BRAINTREE MA
02184-4997
US

IV. Provider business mailing address

111 GROSSMAN DR
BRAINTREE MA
02184-4997
US

V. Phone/Fax

Practice location:
  • Phone: 617-654-7111
  • Fax: 781-849-2452
Mailing address:
  • Phone: 617-654-7111
  • Fax: 781-849-2452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number212827
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: