Healthcare Provider Details

I. General information

NPI: 1730151242
Provider Name (Legal Business Name): EMILY PARKER CHAPMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: EMILY MATTHEWS PARKER

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 CENTRAL AVE N
WAYZATA MN
55391-1206
US

IV. Provider business mailing address

250 CENTRAL AVE N
WAYZATA MN
55391-1206
US

V. Phone/Fax

Practice location:
  • Phone: 952-473-0211
  • Fax: 952-473-7908
Mailing address:
  • Phone: 952-473-0211
  • Fax: 952-473-7908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number40245
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: