Provider Demographics
NPI:1568556298
Name:CHAPA, RICHARD WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:WILLIAM
Last Name:CHAPA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:850 E 300 S
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102-2332
Mailing Address - Country:US
Mailing Address - Phone:801-322-1214
Mailing Address - Fax:801-322-3613
Practice Address - Street 1:850 E 300 S
Practice Address - Street 2:SUITE 1
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-2332
Practice Address - Country:US
Practice Address - Phone:801-322-1214
Practice Address - Fax:801-322-3613
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT159343-1205207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT46D0704114OtherCLIA #
UT87-0280366OtherTAX ID #
UTAC2945220OtherDEA #
UTD07841Medicare UPIN
UT000005350Medicare ID - Type Unspecified