1598804957 NPI number — NICHOLAS CAPOZZOLI & PETER SCHILDER, MD, PA

Table of content: (NPI 1598804957)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598804957 NPI number — NICHOLAS CAPOZZOLI & PETER SCHILDER, MD, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NICHOLAS CAPOZZOLI & PETER SCHILDER, MD, PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598804957
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/08/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
122 DEFENSE HWY
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
ANNAPOLIS
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21401-7069
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-263-9490
Provider Business Mailing Address Fax Number:
410-263-9593

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
122 DEFENSE HWY
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
ANNAPOLIS
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21401-7069
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-263-9490
Provider Business Practice Location Address Fax Number:
410-263-9593
Provider Enumeration Date:
02/05/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CAPOZZOLI
Authorized Official First Name:
NICHOLAS
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
410-263-9490

Provider Taxonomy Codes

  • Taxonomy code: 2084N0400X , with the licence number:  DOO1668O , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: E2380001 . This is a "CAREFIRST BLUE SHIELD" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: LL23NI . This is a "CAREFIRST BLUE SHIELD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".