Provider Demographics
NPI:1255537882
Name:CHAPUT, KIMBERLY JEGEL (DO)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:JEGEL
Last Name:CHAPUT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:701 OSTRUM ST
Mailing Address - Street 2:SUITE 601
Mailing Address - City:FOUNTAIN HILL
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1155
Mailing Address - Country:US
Mailing Address - Phone:610-867-9240
Mailing Address - Fax:610-867-7238
Practice Address - Street 1:701 OSTRUM ST
Practice Address - Street 2:SUITE 601
Practice Address - City:FOUNTAIN HILL
Practice Address - State:PA
Practice Address - Zip Code:18015-1155
Practice Address - Country:US
Practice Address - Phone:610-867-9240
Practice Address - Fax:610-867-7238
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-21
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLJ240513806340207R00000X
PAOS015053207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine