Healthcare Provider Details

I. General information

NPI: 1780801118
Provider Name (Legal Business Name): CHARLES THOMAS CHAPIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

704 26TH ST S
ARLINGTON VA
22202-2402
US

IV. Provider business mailing address

704 26TH ST S
ARLINGTON VA
22202-2402
US

V. Phone/Fax

Practice location:
  • Phone: 703-684-8177
  • Fax: 703-684-8177
Mailing address:
  • Phone: 703-684-8177
  • Fax: 703-684-8177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number0101025119
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: