Basic Information
| Provider Information | |||||||||
| NPI: | 1699775585 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHIPKIN | ||||||||
| FirstName: | STUART | ||||||||
| MiddleName: | ROSS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 8019 | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011028000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8664314077 | ||||||||
| FaxNumber: | 4137747448 | ||||||||
| Practice Location | |||||||||
| Address1: | 31 HALL DR | ||||||||
| Address2: | AMHERST MEDICAL CENTER | ||||||||
| City: | AMHERST | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010022751 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4132568561 | ||||||||
| FaxNumber: | 4132564412 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2005 | ||||||||
| LastUpdateDate: | 06/16/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RE0101X | 52718 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
ID Information
| ID | Type | State | Issuer | Description | 052718 | 01 | MA | TUFTS | OTHER | 5581453 | 01 | MA | AETNA | OTHER | 6178839 | 05 | MA | MEDICAID | AA21834L | 01 | MA | HARVARD PILGRIM HEALTH CARE | OTHER | 00000415784 | 01 | MA | UNITED HEALTH CARE | OTHER | 484718 | 01 | MA | CONNECTICARE | OTHER | 000000029428 | 01 | MA | BMC | OTHER | 7698912 | 01 | MA | CIGNA | OTHER | 23581 | 01 | MA | HNE | OTHER | 49115 | 01 | MA | FALLON | OTHER | J03386 | 01 | MA | BLUE CROSS & BLUE SHIELD | OTHER |