Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 9800803 | NC |
NPI | 1508815457 |
---|---|
Provider Name | Michelle C Capizzi |
First Address | Charlotte, NC 28211-0035 |
Second Address | Charlotte, NC 28211-0035 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2006 |
Last Update Date | 28/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1361R | BCBSNC (01) | NC |
89-1361R | (05) | NC |
F26917 | (02) | |
N0080F | (05) | SC |