=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306913033
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANDREW E CHAPMAN DO
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/29/2006
-----------------------------------------------------
Last Update Date | 11/02/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 925 CHESTNUT ST SUITE 320A
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19107-4216
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-955-8874
-----------------------------------------------------
Fax | 215-955-2340
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1 W ELM ST STE 100
-----------------------------------------------------
City | CONSHOHOCKEN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19428-4108
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-955-8874
-----------------------------------------------------
Fax | 215-955-2340
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RH0003X
-----------------------------------------------------
Taxonomy Name | Hematology & Oncology Physician
-----------------------------------------------------
License Number | 25MB10079700
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RH0003X
-----------------------------------------------------
Taxonomy Name | Hematology & Oncology Physician
-----------------------------------------------------
License Number | OS006594L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------