Provider Demographics
NPI:1043262645
Name:VANEPPS, KEITH CHAPIN (MD)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:CHAPIN
Last Name:VANEPPS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 UNION AVE
Mailing Address - Street 2:SUITE 187
Mailing Address - City:DOVER
Mailing Address - State:OH
Mailing Address - Zip Code:44622-3004
Mailing Address - Country:US
Mailing Address - Phone:330-343-4411
Mailing Address - Fax:330-364-1114
Practice Address - Street 1:515 UNION AVE
Practice Address - Street 2:SUITE 187
Practice Address - City:DOVER
Practice Address - State:OH
Practice Address - Zip Code:44622-3004
Practice Address - Country:US
Practice Address - Phone:330-343-4411
Practice Address - Fax:330-364-1114
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH3503325207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0169277Medicaid
OH0365374Medicare ID - Type Unspecified
OHA73601Medicare UPIN