Provider Demographics
NPI:1760661078
Name:CAPOBIANCO, CLAIRE MEGAN
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:MEGAN
Last Name:CAPOBIANCO
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:CLAIRE
Other - Middle Name:MEGAN
Other - Last Name:COATES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:211 EXECUTIVE DR STE 11
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-3358
Mailing Address - Country:US
Mailing Address - Phone:302-451-6913
Mailing Address - Fax:302-368-7756
Practice Address - Street 1:12100 BLACK SWAN DRIVE
Practice Address - Street 2:SUITE 201
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-4988
Practice Address - Country:US
Practice Address - Phone:302-644-3311
Practice Address - Fax:302-644-3300
Is Sole Proprietor?:No
Enumeration Date:2007-11-02
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPL00000803213ES0103X
TX1900213ES0103X
DEE10000199213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
1760661078OtherGREAT WEST HEALTHCARE
1760661078OtherUNION LABOR LIFE INSURANCE COMPANY
1760661078OtherDEVON HEALTH SERVICES
TX203612102OtherCSHCN
349330OtherUNISON HEALTH PLAN
1760661078OtherMULTIPLAN, INC.
1760661078OtherCORVEL / CORCARE
1760661078OtherUNITED HEALTH CARE
1184681488OtherCOMMERCIAL INSURANCES
1760661078OtherPRIVATE HEALTHCARE SYSTEMS/UNICARE
1760661078OtherCOVENTRY HEALTH CARE OF DELAWARE
DE1760661078Medicaid
1760661078OtherCIGNA
1760661078OtherHEALTH NET FEDERAL SERVICES - TRICARE/CHAMPUS
1760661078OtherEASTERN SUSSEX PHYSICIANS ORGANIZATION (ESPO)
TX203612101Medicaid
1760661078OtherONE NET PPO, MAMSI, OPTIMUM CHOICE, M.D. IPA
1760661078OtherPERDUE FARMS, INC.
1760661078OtherCOMMUNITY HEALTH PLAN
1760661078OtherMULTIPLAN, INC.
6189710001Medicare NSC