Provider Demographics
NPI:1891749578
Name:CHUIPEK, STEPHANIE ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:ANN
Last Name:CHUIPEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:630 FAIRVIEW RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SWARTHMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19081-2334
Mailing Address - Country:US
Mailing Address - Phone:610-541-0155
Mailing Address - Fax:610-541-0158
Practice Address - Street 1:630 FAIRVIEW RD
Practice Address - Street 2:SUITE 210
Practice Address - City:SWARTHMORE
Practice Address - State:PA
Practice Address - Zip Code:19081-2334
Practice Address - Country:US
Practice Address - Phone:610-541-0155
Practice Address - Fax:610-541-0158
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD032786E208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA814343OtherAETNA
PA1079506OtherKEYSTONE MERCY
PA539846OtherBLUE CROSS
PA0115790001OtherKEYSTONE HEALTH PLAN EAST
PA1049219439OtherHEALTH PARTNERS
PA1232108Medicaid
PAE52885Medicare UPIN
PA1079506OtherKEYSTONE MERCY