Provider Demographics
NPI:1063925345
Name:CHAPMAN, WILLIAM HENRY HARRISON IV (MPH, RD, RDN)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:HENRY HARRISON
Last Name:CHAPMAN
Suffix:IV
Gender:M
Credentials:MPH, RD, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3404A ELLSWORTH DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-2133
Mailing Address - Country:US
Mailing Address - Phone:252-414-4054
Mailing Address - Fax:
Practice Address - Street 1:3404A ELLSWORTH DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-2133
Practice Address - Country:US
Practice Address - Phone:252-414-4054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-09
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL005349133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered