Provider Demographics
NPI:1689659120
Name:CHLPKA, PAUL M JR (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:M
Last Name:CHLPKA
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:585 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-2004
Mailing Address - Country:US
Mailing Address - Phone:724-346-6494
Mailing Address - Fax:724-346-3018
Practice Address - Street 1:585 E STATE ST
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:PA
Practice Address - Zip Code:16146-2004
Practice Address - Country:US
Practice Address - Phone:724-346-6494
Practice Address - Fax:724-346-9380
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD067603L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHMD067603LOtherOHIO LICENSE NUMBE3R
PA0018030000004Medicaid
OH2148152Medicaid
PAMD067603LOtherPA LICENSE NUMBER
PAMD067603LOtherPA LICENSE NUMBER