Provider Demographics
NPI:1194810689
Name:CAPUTY, GREGORY GARY (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:GARY
Last Name:CAPUTY
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 PAIKO DR
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96821-2321
Mailing Address - Country:US
Mailing Address - Phone:808-394-2425
Mailing Address - Fax:
Practice Address - Street 1:246 PAIKO DR
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96821-2321
Practice Address - Country:US
Practice Address - Phone:808-394-2425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD8495208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIF91140Medicare UPIN