Provider Demographics
NPI:1326104878
Name:CHAPPELL, MICHAEL CHASE (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:CHASE
Last Name:CHAPPELL
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 1:3115D BRUSHY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-0903
Mailing Address - Country:US
Mailing Address - Phone:864-877-4221
Mailing Address - Fax:864-877-1711
Practice Address - Street 1:3115D BRUSHY CREEK RD
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-0903
Practice Address - Country:US
Practice Address - Phone:864-877-4221
Practice Address - Fax:864-877-1711
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC14927207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC149271Medicaid
SCF19046Medicare UPIN
SC149271Medicaid