Provider Demographics
NPI:1790964815
Name:JAMES E. CHAPPELL, M.D., P.A.
Entity Type:Organization
Organization Name:JAMES E. CHAPPELL, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:CHAPPELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-544-2487
Mailing Address - Street 1:790 RITCHIE HWY
Mailing Address - Street 2:SUITE # E-35
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-4136
Mailing Address - Country:US
Mailing Address - Phone:410-544-2487
Mailing Address - Fax:
Practice Address - Street 1:790 RITCHIE HWY
Practice Address - Street 2:SUITE # E-35
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-4136
Practice Address - Country:US
Practice Address - Phone:410-544-2487
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0053487208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDKG45JAOtherCAREFIRST, MARYLAND
MD261100700Medicaid
MDG96773OtherUPIN
MDW306OtherBLUE CHOICE
MDG96773OtherUPIN