Provider Demographics
NPI:1467516898
Name:CHAPMAN, ROBERT EUGENE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:EUGENE
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13425 DETROIT AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-4608
Mailing Address - Country:US
Mailing Address - Phone:216-228-3500
Mailing Address - Fax:216-228-5818
Practice Address - Street 1:13425 DETROIT AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107-4608
Practice Address - Country:US
Practice Address - Phone:216-228-3500
Practice Address - Fax:216-228-5818
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3992103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCHCP14631Medicare ID - Type UnspecifiedPSYCHOLOGIST