Provider Demographics
NPI:1174701635
Name:CHAPATON-RIVARD, ELISABETH RENEE (DO)
Entity type:Individual
Prefix:DR
First Name:ELISABETH
Middle Name:RENEE
Last Name:CHAPATON-RIVARD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9450 S. SAGINAW
Mailing Address - Street 2:SUITE E
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439
Mailing Address - Country:US
Mailing Address - Phone:810-695-4000
Mailing Address - Fax:810-695-4055
Practice Address - Street 1:9450 S SAGINAW
Practice Address - Street 2:SUITE E
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439
Practice Address - Country:US
Practice Address - Phone:810-695-4000
Practice Address - Fax:810-695-4055
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-07
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS18116207RP1001X, 207RC0200X
MI5101017427207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL119454000Medicaid
FLRM957OtherHFMG MA