Provider Demographics
NPI:1497173439
Name:CHAPMAN, PAMELA C (DO)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:C
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5861 CORTEZ RD W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34210-2704
Mailing Address - Country:US
Mailing Address - Phone:941-202-2106
Mailing Address - Fax:941-202-5506
Practice Address - Street 1:5861 CORTEZ RD W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-2704
Practice Address - Country:US
Practice Address - Phone:941-202-2106
Practice Address - Fax:941-202-5506
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-06
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLOS14096207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program