Provider Demographics
NPI:1750349957
Name:CHAPMAN, BERTRAND G (MD)
Entity type:Individual
Prefix:DR
First Name:BERTRAND
Middle Name:G
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:511 W GROVE ST
Mailing Address - Street 2:STE 201
Mailing Address - City:MIDDLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02346
Mailing Address - Country:US
Mailing Address - Phone:508-947-7610
Mailing Address - Fax:508-946-2691
Practice Address - Street 1:511 W GROVE ST
Practice Address - Street 2:STE 201
Practice Address - City:MIDDLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02346
Practice Address - Country:US
Practice Address - Phone:508-947-7610
Practice Address - Fax:508-946-2691
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2009-10-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA43452207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2075083Medicaid
MP4451488OtherAETNA
MAB10396801OtherCIGNA
MAM17778OtherBCBS
MA7013OtherHARVARD PILGRIM HLTHCARE
MA000000026453OtherBOSTON MED CTR HEALTHNET
MA043452OtherTUFTS HEALTH PLAN
MA7013OtherHARVARD PILGRIM HLTHCARE
B75155Medicare UPIN