MEDICARE: DR. FREDY O CHAPARRO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0200X	Infectious Disease Physician	MD459512	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154586741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FREDY O CHAPARRO M.D.

Provider Business Mailing Address
First Line	:	100 E LANCASTER AVE
Second Line	:	MOB EAST 556
City	:	WYNNEWOOD
State	:	PA
Zip	:	19096-3435
Country	:	US
Telephone Number	:	610-896-0210
Fax Number	:	610-896-5101

Provider Business Practice Location Address
First Line	:	100 E LANCASTER AVE STE 556
Second Line	:
City	:	WYNNEWOOD
State	:	PA
Zip	:	19096-3435
Country	:	US
Telephone Number	:	610-896-0210
Fax Number	:	610-896-5101

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2008
Last Update Date	:	07/21/2022

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