Provider Demographics
NPI:1033235924
Name:KAPPES, THOMAS P (DC)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:P
Last Name:KAPPES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11032 NICHOLAS LANE
Mailing Address - Street 2:SUITE 102A
Mailing Address - City:BERLIN
Mailing Address - State:MD
Mailing Address - Zip Code:21811
Mailing Address - Country:US
Mailing Address - Phone:410-208-0777
Mailing Address - Fax:410-208-6757
Practice Address - Street 1:11032 NICHOLAS LANE
Practice Address - Street 2:SUITE 102A
Practice Address - City:BERLIN
Practice Address - State:MD
Practice Address - Zip Code:21811
Practice Address - Country:US
Practice Address - Phone:410-208-0777
Practice Address - Fax:410-208-6757
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01526111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD21851144OtherOXFORD HEALTH
MD2121665OtherMAMSI
MD8873361OtherCIGNA
MDR3060001OtherBLUE CROSS
MD8873361OtherCIGNA
MDM396Medicare ID - Type Unspecified
MDM396Medicare PIN