Provider Demographics
NPI:1275017576
Name:CAPPAERT, GUSTAV NEIL (PA-C)
Entity Type:Individual
Prefix:
First Name:GUSTAV
Middle Name:NEIL
Last Name:CAPPAERT
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 CALEDONIA RD APT 213
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-0905
Mailing Address - Country:US
Mailing Address - Phone:734-945-3463
Mailing Address - Fax:
Practice Address - Street 1:77 MCDOWELL ST
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4435
Practice Address - Country:US
Practice Address - Phone:828-257-4745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-21
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-08467363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0010-08467OtherNORTH CAROLINA MEDICAL BOARD