Provider Demographics
NPI:1003224601
Name:CAPAUL, NICHOLAS DAVID (MA)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:DAVID
Last Name:CAPAUL
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 S MONROE ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48161-1430
Mailing Address - Country:US
Mailing Address - Phone:734-639-2262
Mailing Address - Fax:734-264-4114
Practice Address - Street 1:750 S MONROE ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48161-1430
Practice Address - Country:US
Practice Address - Phone:734-639-2262
Practice Address - Fax:734-264-4114
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-27
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program