Provider Demographics
NPI:1265824767
Name:CHAPLER, SUSAN PATRICIA (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:PATRICIA
Last Name:CHAPLER
Suffix:
Gender:F
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:PO BOX 1076
Mailing Address - Street 2:
Mailing Address - City:GUALALA
Mailing Address - State:CA
Mailing Address - Zip Code:95445-1076
Mailing Address - Country:US
Mailing Address - Phone:707-884-9078
Mailing Address - Fax:
Practice Address - Street 1:44710 MOONRISE DR
Practice Address - Street 2:
Practice Address - City:GUALALA
Practice Address - State:CA
Practice Address - Zip Code:95445-7503
Practice Address - Country:US
Practice Address - Phone:707-884-9078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-20
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD048892L208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice