MEDICARE: HOLLY M CHAPMAN PA

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	363AM0700X	Medical Physician Assistant	99021443A	IN
2	363A00000X	Physician Assistant	10000882A	IN

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	:	1346275963
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOLLY M CHAPMAN PA

Provider Business Mailing Address
First Line	:	PO BOX 781076
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48278-1076
Country	:	US
Telephone Number	:	317-528-4800
Fax Number	:	317-865-1479

Provider Business Practice Location Address
First Line	:	1205 HADLEY RD STE 200
Second Line	:
City	:	MOORESVILLE
State	:	IN
Zip	:	46158-1934
Country	:	US
Telephone Number	:	317-834-9393
Fax Number	:	317-834-9399

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

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	04/14/2023

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Directions to “ HOLLY M CHAPMAN PA” Practice Location

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