Provider Demographics
NPI:1235235912
Name:CHIPMAN, STEPHEN R (DPM)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:R
Last Name:CHIPMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 163
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00821-0163
Mailing Address - Country:US
Mailing Address - Phone:340-773-5006
Mailing Address - Fax:340-773-7976
Practice Address - Street 1:9A LA GRANDE PRINCESS
Practice Address - Street 2:SUITE 4
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00820
Practice Address - Country:US
Practice Address - Phone:340-773-5006
Practice Address - Fax:340-773-7976
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI933213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U63925Medicare UPIN
48029Medicare PIN