Provider Demographics
NPI:1093343808
Name:CAPUCO, ALEXANDER THOMAS (MD)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:THOMAS
Last Name:CAPUCO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 O ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20057-0002
Mailing Address - Country:US
Mailing Address - Phone:202-687-6985
Mailing Address - Fax:603-704-9186
Practice Address - Street 1:3700 O ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20057-0002
Practice Address - Country:US
Practice Address - Phone:202-687-6985
Practice Address - Fax:202-687-6158
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-28
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD6000017832084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry