Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0105X | Surgery of the Hand | 0101251190 | VA |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 0101251190 | VA |
NPI | 1427260405 |
---|---|
Provider Name | Dr. Anthony E Capito |
First Address | Roanoke, VA 24016-4955 |
Second Address | Roanoke, VA 24016-4955 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2007 |
Last Update Date | 10/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
355859 | (05) | SC |