Provider Demographics
NPI:1881886695
Name:RICHARD L. CHAPIN, DPM
Entity type:Organization
Organization Name:RICHARD L. CHAPIN, DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:LLOYD
Authorized Official - Last Name:CHAPIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:989-723-8106
Mailing Address - Street 1:327 E NORTH ST
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-1822
Mailing Address - Country:US
Mailing Address - Phone:989-723-8106
Mailing Address - Fax:989-723-8107
Practice Address - Street 1:327 E NORTH ST
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-1822
Practice Address - Country:US
Practice Address - Phone:989-723-8106
Practice Address - Fax:989-723-8107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901000862213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5785000OtherBLUE CROSS BLUE SHIELD
791480388AOtherPALMETTO GBA
MI5785000Medicare PIN
MI5785000OtherBLUE CROSS BLUE SHIELD
MI0234180001Medicare NSC