Provider Demographics
NPI:1043344583
Name:A. BRADLEY CHAPMAN MD AND FRANK E. MICHENER MD LTD.
Entity Type:Organization
Organization Name:A. BRADLEY CHAPMAN MD AND FRANK E. MICHENER MD LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:E
Authorized Official - Last Name:MICHENER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-960-4901
Mailing Address - Street 1:2059 HUNTINGTON AVE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22303-1636
Mailing Address - Country:US
Mailing Address - Phone:703-960-4901
Mailing Address - Fax:703-960-4952
Practice Address - Street 1:2059 HUNTINGTON AVE
Practice Address - Street 2:SUITE 108
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22303-1636
Practice Address - Country:US
Practice Address - Phone:703-960-4901
Practice Address - Fax:703-960-4952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010240432084P0800X
VA01010214742084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7109661Medicaid
B93087Medicare UPIN
408530Medicare ID - Type UnspecifiedDR. CHAPMAN
C88640Medicare UPIN
066814Medicare ID - Type UnspecifiedDR. MICHENER