Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | CH7333 | FL |
NPI | 1447451307 |
---|---|
Provider Name | Dr. Tim D Chapman |
First Address | Oviedo, FL 32765-6456 |
Second Address | Oviedo, FL 32765-6456 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2007 |
Last Update Date | 08/05/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
381038100 | (05) | FL |
U80539 | (02) | FL |