Provider Demographics
NPI:1790739944
Name:CHALPIN, DAVID BRET (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BRET
Last Name:CHALPIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1542 TULANE AVENUE, ROOM 353
Mailing Address - Street 2:LSU HEALTH SCIENCES CENTER, DEPARTMENT OF RADIOLOGY
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112
Mailing Address - Country:US
Mailing Address - Phone:504-568-4647
Mailing Address - Fax:504-568-8955
Practice Address - Street 1:1542 TULANE AVENUE, ROOM 353
Practice Address - Street 2:LSU HEALTH SCIENCES CENTER, DEPARTMENT OF RADIOLOGY
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112
Practice Address - Country:US
Practice Address - Phone:504-568-4647
Practice Address - Fax:504-568-8955
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-20
Last Update Date:2009-12-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA0525132085R0202X
LAMD.09993R2085R0202X
MS177652085R0202X
ALMD.248922085R0202X
CAG639552085R0202X
TN0360902085R0202X
TXL63152085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA627813305AMedicaid
30BDMRRMedicare ID - Type Unspecified
GA627813305AMedicaid