Provider Demographics
NPI:1013393297
Name:CHAPMAN, CARLY (DPM)
Entity Type:Individual
Prefix:DR
First Name:CARLY
Middle Name:
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:CARLY
Other - Middle Name:MARIE
Other - Last Name:EARGLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1516 CALHOUN ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-2607
Mailing Address - Country:US
Mailing Address - Phone:803-254-6114
Mailing Address - Fax:803-254-7674
Practice Address - Street 1:1516 CALHOUN ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201
Practice Address - Country:US
Practice Address - Phone:803-254-6114
Practice Address - Fax:803-254-7674
Is Sole Proprietor?:No
Enumeration Date:2015-08-10
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC656213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery