Healthcare Provider Details

I. General information

NPI: 1346275716
Provider Name (Legal Business Name): DANIEL S CHAPMAN PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 12/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 OLD ETNA RD DEPARTMENT OF GENERAL INTERNAL MEDICINE
LEBANON NH
03766
US

IV. Provider business mailing address

ONE MEDICAL CENTER DRIVE DEPARTMENT OF GENERAL INTERNAL MEDICINE
LEBANON NH
03756-0001
US

V. Phone/Fax

Practice location:
  • Phone: 603-650-4000
  • Fax: 603-650-4190
Mailing address:
  • Phone: 603-650-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0896
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: