Provider Demographics
NPI:1053384875
Name:KNAPPMAN, JOHN W (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:W
Last Name:KNAPPMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 11406
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4005
Mailing Address - Country:US
Mailing Address - Phone:321-452-4470
Mailing Address - Fax:321-452-4442
Practice Address - Street 1:2404 N COURTENAY PKWY
Practice Address - Street 2:SUITE D
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32953-4191
Practice Address - Country:US
Practice Address - Phone:321-452-4470
Practice Address - Fax:321-452-4442
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL0051565207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL251527000Medicaid
FL05846XMedicare PIN
FLB42159Medicare UPIN