Provider Demographics
NPI:1417956293
Name:CHIPMAN, HOWARD N III (MD)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:N
Last Name:CHIPMAN
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3705 TAMPA RD
Mailing Address - Street 2:STE 22
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-6300
Mailing Address - Country:US
Mailing Address - Phone:813-891-6343
Mailing Address - Fax:813-891-6342
Practice Address - Street 1:3705 TAMPA RD
Practice Address - Street 2:STE 22
Practice Address - City:OLDSMAR
Practice Address - State:FL
Practice Address - Zip Code:34677-6300
Practice Address - Country:US
Practice Address - Phone:813-891-6343
Practice Address - Fax:813-891-6342
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0050526207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E21396Medicare UPIN
FL07676Medicare ID - Type Unspecified
FL24964Medicare ID - Type UnspecifiedGROUP