Provider Demographics
NPI:1467251546
Name:CHALOUPKA, EVAN
Entity type:Individual
Prefix:
First Name:EVAN
Middle Name:
Last Name:CHALOUPKA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 E MOLER ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43207-1240
Mailing Address - Country:US
Mailing Address - Phone:216-203-1448
Mailing Address - Fax:
Practice Address - Street 1:335 E MOLER ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43207-1240
Practice Address - Country:US
Practice Address - Phone:216-203-1448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker