Provider Demographics
NPI:1497027957
Name:EDWIN C CHAPMAN MD PC
Entity Type:Organization
Organization Name:EDWIN C CHAPMAN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-396-8550
Mailing Address - Street 1:1647 BENNING RD NE
Mailing Address - Street 2:200
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-4569
Mailing Address - Country:US
Mailing Address - Phone:202-396-8550
Mailing Address - Fax:202-388-4461
Practice Address - Street 1:1647 BENNING RD NE
Practice Address - Street 2:200
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-4569
Practice Address - Country:US
Practice Address - Phone:202-396-8550
Practice Address - Fax:202-388-4461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-30
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC10544207R00000X, 207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC1841303880OtherMAIL HANDLERS
DC1841303880OtherUNITED HEALTHCARE
DC159324OtherMEDICARE PTAN
DC1841303880OtherAETNA
1841303880OtherBC/BS
DC1841303880Medicaid
DC159324OtherMEDICARE PTAN
DC1841303880Medicaid