Provider Demographics
NPI:1205806262
Name:CHAPEL, DAN M (MD)
Entity type:Individual
Prefix:DR
First Name:DAN
Middle Name:M
Last Name:CHAPEL
Suffix:
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 1:4530 E SHEA BLVD STE 180
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-6042
Mailing Address - Country:US
Mailing Address - Phone:602-264-4834
Mailing Address - Fax:602-254-5178
Practice Address - Street 1:4530 E SHEA BLVD STE 180
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-6042
Practice Address - Country:US
Practice Address - Phone:602-264-4834
Practice Address - Fax:602-254-5178
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ19533207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0819130OtherBC/BS PROVIDER ID
AZ296287Medicaid
AZ799702Medicaid
AZ296287Medicaid
AZ799702Medicaid