Provider Demographics
NPI:1316934698
Name:CHAPMAN, SUSAN (MD)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:642 ULUKAHIKI ST
Mailing Address - Street 2:STE 305
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-4400
Mailing Address - Country:US
Mailing Address - Phone:808-261-6644
Mailing Address - Fax:808-261-6645
Practice Address - Street 1:642 ULUKAHIKI ST
Practice Address - Street 2:STE 305
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-4400
Practice Address - Country:US
Practice Address - Phone:808-261-6644
Practice Address - Fax:808-261-6645
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-03
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD4609207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00210501Medicaid
B016259OtherHMSA
192256OtherSUMMERIN
MD4609OtherQUEENS
867OtherALOHACARE
HI0000BDLGMMedicare PIN
C98735Medicare UPIN