Provider Demographics
NPI:1336120633
Name:MCGRAIL, CAPRICE D (MD)
Entity Type:Individual
Prefix:DR
First Name:CAPRICE
Middle Name:D
Last Name:MCGRAIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CAPRICE
Other - Middle Name:
Other - Last Name:HERRON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:11300 E 13 MILE RD
Mailing Address - Street 2:STE 4
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-2500
Mailing Address - Country:US
Mailing Address - Phone:586-574-1313
Mailing Address - Fax:586-574-0842
Practice Address - Street 1:11300 E 13 MILE RD
Practice Address - Street 2:STE 4A
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-2500
Practice Address - Country:US
Practice Address - Phone:586-574-1313
Practice Address - Fax:586-574-0842
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301076384207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I12974Medicare UPIN
M22540005Medicare ID - Type Unspecified