Provider Demographics
NPI:1548400815
Name:CHAPPUIES, DUANE L
Entity Type:Individual
Prefix:MR
First Name:DUANE
Middle Name:L
Last Name:CHAPPUIES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1681 W OLD STATE RD
Mailing Address - Street 2:P.O. BOX 359
Mailing Address - City:EAST JORDAN
Mailing Address - State:MI
Mailing Address - Zip Code:49727-8860
Mailing Address - Country:US
Mailing Address - Phone:231-536-7657
Mailing Address - Fax:231-544-5408
Practice Address - Street 1:2424 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CENTRAL LAKE
Practice Address - State:MI
Practice Address - Zip Code:49622-9271
Practice Address - Country:US
Practice Address - Phone:231-544-2929
Practice Address - Fax:231-544-5408
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-26
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302022452183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist