Provider Demographics
NPI:1699752147
Name:CHAPMAN, CYNTHIA ROBIN (PA-C)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:ROBIN
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 217
Mailing Address - Street 2:
Mailing Address - City:ROCK CAVE
Mailing Address - State:WV
Mailing Address - Zip Code:26234-0217
Mailing Address - Country:US
Mailing Address - Phone:304-924-6262
Mailing Address - Fax:304-924-5460
Practice Address - Street 1:ROUTE 4 & 20 INTERSECTION SOUTH
Practice Address - Street 2:
Practice Address - City:ROCK CAVE
Practice Address - State:WV
Practice Address - Zip Code:26234
Practice Address - Country:US
Practice Address - Phone:304-924-6262
Practice Address - Fax:304-924-5460
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV266363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV970003984OtherRAILROAD MEDICARE
WV2032306Medicare PIN
WV2032302Medicare PIN
WV2032301Medicare PIN
WV970003984OtherRAILROAD MEDICARE
WV2032303Medicare PIN
WV2032304Medicare PIN