Provider Demographics
NPI:1669650958
Name:KAREN L. CHAPEL MD PC
Entity Type:Organization
Organization Name:KAREN L. CHAPEL MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARREDONDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-561-5311
Mailing Address - Street 1:2814 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-3473
Mailing Address - Country:US
Mailing Address - Phone:313-561-5311
Mailing Address - Fax:313-561-2504
Practice Address - Street 1:2814 MONROE ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-3473
Practice Address - Country:US
Practice Address - Phone:313-561-5311
Practice Address - Fax:313-561-2504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-08
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P54210Medicare PIN
MI0827049Medicare PIN
MI1822913Medicare PIN
MI0M67090Medicare PIN