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Individual

MR. CLIFFORD ARTHUR CHAPIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
512 SKYLINE BLVD, CLOQUET, MN 55720-1199
(218) 879-4641
(218) 878-7086
Mailing address
512 SKYLINE BLVD, CLOQUET, MN 55720-1199
(218) 879-4641
(218) 878-7086

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
42643
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01Y0072420VH03
ANTHEM
01
1009726
VTW
VT
01
26568
CIGNA
NH
05
30204411
NH
01
421750814
TAX ID
NH
01
5070
TRICARE
HI
01
68117
VT BLUE
VT
01
785935
MVP
VT
01
AA37351
HARVARD PILGRIM
01
S01Y007242NH02
NH
NH
Enumeration date
11/07/2005
Last updated
04/24/2017
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