Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 25MFL01921800 | NJ |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | 28915 | PA |
NPI | 1982896890 |
---|---|
Provider Name | Dr. Philip Charles Chapalis |
First Address | Jenkintown, PA 19046 |
Second Address | Toms River, NJ 08753 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2007 |
Last Update Date | 14/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C53206 | (02) |