Provider Demographics
NPI:1154386837
Name:CAPIZZI, PETER JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:JOSEPH
Last Name:CAPIZZI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5924 MARSAILLES CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-2595
Mailing Address - Country:US
Mailing Address - Phone:704-540-9057
Mailing Address - Fax:704-540-2276
Practice Address - Street 1:8712 LINDHOLM DR
Practice Address - Street 2:SUITE 308
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-1870
Practice Address - Country:US
Practice Address - Phone:704-655-8988
Practice Address - Fax:704-655-8980
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC76196208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC10329OtherBCBS
NC8910329Medicaid
NC8910329Medicaid