Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | DS018683L | PA |
NPI | 1164428058 |
---|---|
Provider Name | Dr. Medick Michael Capirano |
First Address | Pittsburgh, PA 15236-1582 |
Second Address | Pittsburgh, PA 15226-2503 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2005 |
Last Update Date | 22/05/2012 |