Provider Demographics
NPI:1598345068
Name:CHAPMAN, CARLY MICHAL (DO)
Entity type:Individual
Prefix:
First Name:CARLY
Middle Name:MICHAL
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4055 ROY WILSON WAY
Mailing Address - Street 2:
Mailing Address - City:NEW PALESTINE
Mailing Address - State:IN
Mailing Address - Zip Code:46163-8032
Mailing Address - Country:US
Mailing Address - Phone:317-861-4171
Mailing Address - Fax:317-861-5325
Practice Address - Street 1:4055 ROY WILSON WAY
Practice Address - Street 2:
Practice Address - City:NEW PALESTINE
Practice Address - State:IN
Practice Address - Zip Code:46163-8032
Practice Address - Country:US
Practice Address - Phone:317-861-4171
Practice Address - Fax:317-861-5325
Is Sole Proprietor?:No
Enumeration Date:2021-04-09
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN02007343A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine