Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 2007-01149 | NC |
N | 208600000X | Surgeon | 2007-01149 | NC |
Y | 208200000X | Surgeon | 4301093139 | MI |
Y | 208600000X | Surgeon | 4301093139 | MI |
N | 2086S0102X | Surgical Critical Care | 4301093139 | MI |
N | 2086S0120X | Pediatric Surgery | 4301093139 | MI |
NPI | 1205035888 |
---|---|
Provider Name | Dr. Tony Richard Capizzani |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48109-5245 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2007 |
Last Update Date | 09/07/2009 |