Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35-131897 | OH |
Y | 2080P0208X | Pediatric Infectious Diseases | 35-131897 | OH |
NPI | 1417110529 |
---|---|
Provider Name | Juan Demetrio Chaparro |
First Address | Columbus, OH 43205-2664 |
Second Address | Columbus, OH 43205-2664 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2008 |
Last Update Date | 14/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0234319 | (05) | OH |
H593630 | CGS - MEDICARE (01) | OH |