Provider Demographics
NPI:1366462459
Name:CARACAPPA, PAUL MICHAEL (DO)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:MICHAEL
Last Name:CARACAPPA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 300
Mailing Address - Street 2:
Mailing Address - City:WYCOMBE
Mailing Address - State:PA
Mailing Address - Zip Code:18980-0300
Mailing Address - Country:US
Mailing Address - Phone:215-598-1200
Mailing Address - Fax:
Practice Address - Street 1:2324 SECOND STREET PIKE
Practice Address - Street 2:
Practice Address - City:WRIGHTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-4110
Practice Address - Country:US
Practice Address - Phone:215-598-1200
Practice Address - Fax:215-598-1201
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS-006826-L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAE92595Medicare UPIN