Provider Demographics
NPI:1669046249
Name:CHAPMAN, MICHAEL ALEXANDER
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ALEXANDER
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:559 WILLARD ST APT 11
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-6234
Mailing Address - Country:US
Mailing Address - Phone:781-741-0154
Mailing Address - Fax:
Practice Address - Street 1:25 RECREATION PARK DR STE 112
Practice Address - Street 2:
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-4256
Practice Address - Country:US
Practice Address - Phone:781-982-5566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-18
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3719111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor